Health Equity (May 2024)

Closing the Sex-Based Differences in Stroke Care: Insights from a Large Telestroke Network on Treatment and Postacute Management

  • Soledad P?rez-S?nchez,
  • Ana Barrag?n-Prieto,
  • Juan Bautista Loscertales,
  • Juan Antonio Cabezas Rodr?guez,
  • Elena Zapata-Arriaza,
  • Laura Amaya Pascasio,
  • Andr?s Hermos?n G?mez,
  • Miguel ?ngel Gamero Garc?a,
  • Benito Galeano,
  • Javier Fern?ndez,
  • Blanca Pardo Galiana,
  • Ana Dom?nguez Mayoral,
  • Leire Ainz G?mez,
  • Jose Fern?ndez Navarro,
  • Cristina del Toro,
  • Manuel Medina,
  • Reyes de Torres,
  • Pablo Baena,
  • Francisco Moniche,
  • Roberto Valverde Moyano,
  • Patricia Mart?nez,
  • Alejandro Gonz?lez,
  • Joan Montaner

DOI
https://doi.org/10.1089/HEQ.2023.0175
Journal volume & issue
Vol. 8, no. 1
pp. 301 – 306

Abstract

Read online

Background: The evolution of ischemic stroke is different accordin'g to sex and is one of the main causes of death in women. Previous studies have shown that women are less likely to receive acute treatment, and stroke center type is an important predictor of door-to-needle times. We investigated whether women are attended in a similar way to men in the telestroke network with specialized stroke physicians. Methods: A prospective registry of ischemic strokes recorded in the centralized Andalusian telestroke network was analyzed, focusing on sex differences. Demographic data, clinical characteristics, neuroimaging data, treatment intervals, follow-up visits, and clinical outcomes were collected. Results: A total of 3009 suspected stroke patients were attended to in the telestroke network from 2019 to 2023, of which 42.74% were women. Women were older (p < 0.001) and less independent upon arrival (p = 0.006) than men. There was no difference in the treatment received or in the treatment time intervals between the groups. Importantly, there was no difference in modified Rankin scale scores at 3 months between sexes. At 3 months post-stroke follow-up, women had fewer imaging tests (p = 0.018) and fewer outpatient visits (p < 0.001) than men. Conclusions: No significant difference between men and women has been found in the acute treatment of stroke in a large telestroke network. However, the same is not true for the follow-up and management of patients after the acute phase. This fact supports that strict adherence to protocols and specialization of care lead to equal care that avoids sex differences in stroke treatment and functional outcomes.

Keywords