Daily Dose: Care for Acute Stroke in Women Less Urgent

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On July 19, 2023, we reported on a study published in the Journal of the American Heart Association that found troubling disparities between men and women in emergency service routing for acute ishemic stroke (AIS).

The study

For the cross-sectional study, the research team identified consecutive patients presenting with large vessel occlusion AIS from a prospectively-collected multihospital registry for the greater Houston area from January 2019 to June 2020. Of the 10 stroke centers included, 6 are primary stroke centers (PSCs) and 4 are comprehensive stroke centers.

The findings

The team found that women with LVO AIS were more likely to be older than men (73 vs 65 years) and to be sicker as determined by National Institutes of Health Stroke Scale score. Despite the more severe presentation, however, multivariable analysis confirmed that women were less likely to be routed to a comprehensive stroke center than men, a disparity that persisted regardless of the comparable promixmity to a stroke center.

Conclusion

The authors conclude, in part, that "...elderly women are more likely to live alone and experience social isolation, which can result in delayed recognition of stroke symptoms and subsequent delays in seeking medical attention. Therefore, appropriate triage and prehospital routing can be even more critical for women."

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