Women With Large Vessel Occlusion acute Ischemic Stroke are Less Likely to Be Routed to Comprehensive Stroke Centers

Authors

Muhammad Bilal Tariq
Iman Ali
Sergio Salazar-Marioni
Ananya S Iyyangar
Hussain M Azeem
Swapnil Khose
Victor Lopez
Rania Abdelkhaleq
Louise D McCullough
Sunil A Sheth
Youngran Kim

Publication Date

7-18-2023

Journal

Journal of the American Heart Association

Abstract

Background Prehospital routing of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) to centers capable of performing endovascular therapy may improve clinical outcomes. Here, we explore whether distance to comprehensive stroke centers (CSCs), stroke severity, and sex are associated with direct-to-CSC prehospital routing in patients with LVO AIS. Methods and Results In this cross-sectional study, we identified consecutive patients with LVO AIS from a prospectively collected multihospital registry throughout the greater Houston area from January 2019 to June 2020. Primary outcome was prehospital routing to CSC and was compared between men and women using modified Poisson regression including age, sex, race or ethnicity, first in-hospital National Institutes of Health Stroke Scale score, travel time, and distances to the closest primary stroke center and CSC. Among 503 patients with LVO AIS, 413 (82%) were routed to CSCs, and women comprised 46% of the study participants. Women with LVO AIS compared with men were older (73 versus 65,

Keywords

Male, Humans, Female, Ischemic Stroke, Brain Ischemia, Cross-Sectional Studies, Stroke, Retrospective Studies