دورية أكاديمية

Sex differences in onset to hospital arrival time, prestroke disability, and clinical symptoms in patients with a large vessel occlusion: a MR CLEAN Registry substudy

التفاصيل البيبلوغرافية
العنوان: Sex differences in onset to hospital arrival time, prestroke disability, and clinical symptoms in patients with a large vessel occlusion: a MR CLEAN Registry substudy
المؤلفون: Ali, Mariam, van der Meij, Anne, van Os, Hendrikus J A, Ali, Mahsoem, Van Zwet, Erik W, Spaander, Fianne H M, Hofmeijer, Jeanette, Nederkoorn, Paul J, van den Wijngaard, Ido R, Majoie, Charles B L M, van Es, Adriaan C G M, Schonewille, Wouter J, van Walderveen, Marianne A A, Dippel, Diederik W J, Visser, Marieke C, Kruyt, Nyika D, Wermer, Marieke J H
المساهمون: Amsterdam University Medical Centers, Stichting Toegepast Wetenschappelijk Instituut voor Neuromodulatie, Maastricht University Medical Center, Erasmus MC, University Medical Center
المصدر: Journal of NeuroInterventional Surgery ; volume 15, issue e2, page e255-e261 ; ISSN 1759-8478 1759-8486
بيانات النشر: BMJ
سنة النشر: 2022
الوصف: Background Women have been reported to have worse outcomes after endovascular treatment (EVT), despite a similar treatment effect in non-clinical trial populations. We aimed to assess sex differences at hospital presentation with respect to workflow metrics, prestroke disability, and presenting clinical symptoms. Methods We included consecutive patients from the Multicentre Randomised Controlled Trial of Endovascular Treatment for Acute Ischaemic Stroke in The Netherlands (MR CLEAN) Registry (2014–2018) who received EVT for anterior circulation large vessel occlusion (LVO). We assessed sex differences in workflow metrics, prestroke disability (modified Rankin Scale (mRS) score ≥1), and stroke severity and symptoms according to the National Institutes of Health Stroke Scale (NIHSS) score on hospital admission with logistic and linear regression analyses and calculated the adjusted OR (aOR). Results We included 4872 patients (47.6% women). Compared with men, women were older (median age 76 vs 70 years) and less often achieved good functional outcome at 90 days (mRS ≤2: 35.2% vs 46.4%, aOR 0.70, 95% CI 0.60 to 0.82). Mean onset-to-door time was longer in women (2 hours 16 min vs 2 hours 7 min, adjusted delay 9 min, 95% CI 4 to 13). This delay contributed to longer onset-to-groin times (3 hours 26 min in women vs 3 hours 13 min in men, adjusted delay 13 min, 95% CI 9 to 17). Women more often had prestroke disability (mRS ≥1: 41.1% vs 29.1%, aOR 1.57, 95% CI 1.36 to 1.82). NIHSS on admission was essentially similar in men and women (mean 15±6 vs 15±6, NIHSS <10 vs ≥10, aOR 0.91, 95% CI 0.78 to 1.06). There were no clear sex differences in the occurrence of specific stroke symptoms. Conclusion Women with LVO had longer onset-to-door times and more often prestroke disability than men. Raising awareness of these differences at hospital presentation and investigating underlying causes may help to improve outcome after EVT in women.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1136/jnis-2022-019670
الإتاحة: https://doi.org/10.1136/jnis-2022-019670Test
رقم الانضمام: edsbas.B570AA6D
قاعدة البيانات: BASE