Gender and Time to Arrival among Ischemic Stroke Patients in the Greater Cincinnati/Northern Kentucky Stroke Study

Abstract

Background Some studies of stroke patients report longer pre-hospital delays in women, but others conflict; studies vary in their inclusion of factors including age and stroke severity. We aimed to investigate the relationship between gender and time to emergency department (ED) arrival and the influence of age and stroke severity on this relationship. Methods Ischemic stroke patients ≥ 20 years old who presented to 15 hospitals within a 5-county region of Greater Cincinnati/Northern Kentucky during 2010 were included. Time from symptom onset to ED arrival and covariates were abstracted by study nurses and reviewed by study physicians. Data were analyzed using logistic regression with time to arrival dichotomized at ≤ 3 hours, in the overall sample and then stratified by NIHSS and age. Results 1991 strokes (55% women) were included. Time to arrival was slightly longer in women (geometric mean 337 minutes [95%CI 307–369] vs. 297 [95%CI 268–329], p =0.05), and 24% of women vs. 27% of men arrived within 3 hours (p=0.15). After adjusting for age, race, NIHSS, living situation, and other covariates, gender was not associated with delayed time to arrival (OR=1.00, 95%CI 0.78–1.28). This did not change across age or NIHSS categories. Conclusions After adjusting for factors including age, NIHSS, and living alone, women and men with ischemic stroke had similar times to arrival. Arrival time is not likely a major contributor to differences in outcome between men and women.

Race-Ethnic Disparities in Hospital Arrival Time after Ischemic Stroke

“…Arrival by ambulance is another factor that has been consistently associated with early hospital arrival after stroke onset. 2,8,9,21,[25][26][27] Accordingly, we found that women using EMS were 3.7 times and men were 3.0 times more likely to arrive to the hospital early. In this study, more Caucasians than Hispanics and African Americans called 911 rather than used private transpor-This study has limitations.…”

Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke

“…The interval between the onset of symptoms and the arrival at the hospital greatly influences the treatment efficacy and the final prognosis of the patient [10]. Most of the studies on prehospital delay (PHD) have focused on the identification of the socio-demographic, clinical, and contextual characteristics of patients who choose not to seek immediate treatment [11,12,13,14]. However, the PHD can also be affected by other behavioral and cognitive factors and features that have hardly been studied [15].…”

Faktor-faktor yang Berhubungan dengan Keterlambatan Kedatangan Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado

“…Beberapa penelitian sebelumnya melaporkan bahwa usia mempunyai hubungan bermakna dengan kedatangan pasien stroke yang lebih awal ke rumah sakit. 12,13 Penelitian yang dilakukan di Cina melaporkan bahwa pasien stroke yang berusia ≥65 tahun memiliki hubungan dengan kedatangan lebih awal di Instalasi Gawat Darurat. Hal tersebut mungkin disebabkan kesadaran akan gejala dan tanda stroke yang lebih tinggi, karena pasien stroke yang berusia ≥65 tahun menjadi sasaran promosi kesehatan.…”

“…Perbedaan waktu kedatangan pada pasien stroke sesuai jenis kelamin pasien kemungkinan merupakan akibat dari kurangnya kemampuan peneliti untuk mengontrol variabelvariabel yang ada dan penggunaan kriteria seleksi pasien yang berbeda-beda pada setiap penelitian. 13 Hasil analisis bivariat menunjukkan bahwa terdapat hubungan bermakna antara tingkat pendidikan dengan keterlambatan kedatangan pasien stroke ke rumah sakit. Hal tersebut selaras dengan penelitian yang dilakukan di India, yaitu pasien stroke yang mempunyai tingkat pendidikan tinggi cenderung memiliki durasi keterlambatan kedatangan di rumah sakit yang lebih singkat.…”