Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct;47(10):2618-26.
doi: 10.1161/STROKEAHA.116.013059. Epub 2016 Aug 23.

Sex Disparities in Ischemic Stroke Care: FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities)

Negar Asdaghi  1 , Jose G Romano  2 , Kefeng Wang  2 , Maria A Ciliberti-Vargas  2 , Sebastian Koch  2 , Hannah Gardener  2 , Chuanhui Dong  2 , David Z Rose  2 , Salina P Waddy  2 , Mary Robichaux  2 , Enid J Garcia  2 , Juan A Gonzalez-Sanchez  2 , W Scott Burgin  2 , Ralph L Sacco  2 , Tatjana Rundek  2
Affiliations

Sex Disparities in Ischemic Stroke Care: FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities)

Negar Asdaghi et al. Stroke. 2016 Oct.

Abstract

Background and purpose: Sex-specific disparities in stroke care including thrombolytic therapy and early hospital admission are reported. In a large registry of Florida and Puerto Rico hospitals participating in the Get With The Guidelines-Stroke program, we sought to determine sex-specific differences in ischemic stroke performance metrics and overall thrombolytic treatment.

Methods: Around 51 317 (49% women) patients were included from 73 sites from 2010 to 2014. Multivariable logistic regression with generalized estimating equations evaluated sex-specific differences in the prespecified Get With The Guidelines-Stroke metrics for defect-free care in ischemic stroke, adjusting for age, race-ethnicity, insurance status, hospital characteristics, individual risk factors, and the presenting stroke severity.

Results: As compared with men, women were older (73±15 versus 69±14 years; P<0.0001), more hypertensive (67% versus 63%, P<0.0001), and had more atrial fibrillation (19% versus 16%; P<0.0001). Defect-free care was slightly lower in women than in men (odds ratio, 0.96; 95% confidence interval, 0.93-1.00). Temporal trends in defect-free care improved substantially and similarly for men and women, with a 29% absolute improvement in women (P<0.0001) and 28% in men (P<0.0001), with P value of 0.13 for time-by-sex interaction. Women were less likely to receive thrombolysis (odds ratio, 0.92; 95% confidence interval, 0.86-0.99; P=0.02) and less likely to have a door-to-needle time <1 hour (odds ratio, 0.83; 95% confidence interval, 0.71-0.97; P=0.02) as compared with men.

Conclusions: Women received comparable stroke care to men in this registry as measured by prespecified Get With The Guidelines metrics. However, women less likely received thrombolysis and had door-to-needle time <1 hour, an observation that calls for the implementation of interventions to reduce sex disparity in these measures.

Keywords: Get With The Guidelines; National Institute of Neurological Disorders and Stroke; sex characteristics; stroke.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The distribution of Defect Free Care from 2010 to 2014 stratified by sex
Figure 2
Figure 2
Outline of patients Who Received Thrombolysis
See this image and copyright information in PMC

References

    1. Bushnell CD, Hurn P, Colton C, Miller VM, del Zoppo G, Elkind MS, et al. Advancing the study of stroke in women: Summary and recommendations for future research from an ninds-sponsored multidisciplinary working group. Stroke; a journal of cerebral circulation. 2006;37:2387–2399. - PubMed
    1. Reeves MJ, Fonarow GC, Zhao X, Smith EE, Schwamm LH, et al. Get With The Guidelines-Stroke Steering C. Quality of care in women with ischemic stroke in the gwtg program. Stroke; a journal of cerebral circulation. 2009;40:1127–1133. - PubMed
    1. Gargano JW, Wehner S, Reeves M. Sex differences in acute stroke care in a statewide stroke registry. Stroke; a journal of cerebral circulation. 2008;39:24–29. - PubMed
    1. Smith MA, Lisabeth LD, Brown DL, Morgenstern LB. Gender comparisons of diagnostic evaluation for ischemic stroke patients. Neurology. 2005;65:855–858. - PubMed
    1. Turaj W, Slowik A, Wnuk M, Szczudlik A. Gender-related differences in diagnostic evaluation and outcome of ischemic stroke in poland. Stroke; a journal of cerebral circulation. 2009;40:980–982. - PubMed

Publication types

Substances