Despite presenting with greater NIHSS score, women were 9 percent less likely to be routed to comprehensive stroke centers
By Elana Gotkine HealthDay Reporter
WEDNESDAY, July 26, 2023 (HealthDay News) — Women with large vessel occlusion (LVO) acute ischemic stroke (AIS) are less likely to be routed to comprehensive stroke centers (CSCs) compared with men, despite presenting with more significant stroke syndromes, according to a study published online July 18 in the Journal of the American Heart Association.
Muhammad Bilal Tariq, M.D., from UTHealth McGovern Medical School in Houston, and colleagues conducted a cross-sectional study involving patients with LVO AIS to examine whether distance to CSCs, stroke severity, and sex are associated with direct-to-CSC prehospital routing. The authors analyzed 503 consecutive patients with LVO AIS from a prospectively collected multihospital Houston registry from January 2019 to June 2020.
The researchers found that 82 percent of the 503 patients with LVO AIS were routed to CSCs. Compared with men, women with LVO AIS were older (73 versus 65 years) and presented with greater National Institutes of Health Stroke Scale scores (14 versus 12). Women were less likely to be routed to CSCs compared with men (adjusted relative risk, 0.91); distance to nearest CSC of ≤10 miles was associated with an increased risk for routing to a CSC (adjusted relative risk, 1.38).
“We don’t know exactly why women were less likely than men to be routed to comprehensive stroke centers, but we do know that gender is an implicit bias,” a coauthor said in a statement. “Getting to the granular level of what went into a hospital’s routing decision will be very important for future studies.”
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