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

Autor:	Pérez-Sánchez S; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Barragán-Prieto A; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Loscertales JB; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Cabezas Rodríguez JA; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Zapata-Arriaza E; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Radiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Amaya Pascasio L; Department of Neurology, Hospital Universitario Torrecárdenas, Almería, Spain., Hermosín Gómez A; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Gamero García MÁ; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Galeano B; Department of Neurology, Hospital Universitario Puerta del Mar, Cádiz, Spain., Fernández J; Department of Neurology, Hospital Universitario Torrecárdenas, Almería, Spain., Pardo Galiana B; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Domínguez Mayoral A; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Ainz Gómez L; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Fernández Navarro J; Department of Neurology, Hospital Universitario Puerta del Mar, Cádiz, Spain., Del Toro C; Department of Neurology, Hospital Universitario Torrecárdenas, Almería, Spain., Medina M; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., de Torres R; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain., Baena P; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Moniche F; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Valverde Moyano R; Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, Spain., Martínez P; Department of Neurology, Hospital Universitario Torrecárdenas, Almería, Spain., González A; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.; Department of Radiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Montaner J; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.; Neurovascular Research Group, Instituto de Biomedicina de Sevilla-IBiS, Sevilla, Spain.
Jazyk:	angličtina
Zdroj:	Health equity [Health Equity] 2024 May 10; Vol. 8 (1), pp. 301-306. Date of Electronic Publication: 2024 May 10 (Print Publication: 2024).
DOI:	10.1089/heq.2023.0175
Abstrakt:	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. (© Soledad Pérez-Sánchez et al., 2024; Published by Mary Ann Liebert, Inc.)
Databáze:	MEDLINE
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