Even though women with stroke are more likely than men to get to the hospital by ambulance, their care is less likely to follow a smooth path along the way, researchers at the George Institute for Global Health and Medicine and Health found. of the UNSW. There was also an effect of age, as ambulance staff were more likely to miss a stroke diagnosis in women younger than 70 than in younger men.
In a population-based cohort study, published today in the Medical Journal of Australia, researchers conducted an analysis of data collection from linked admitted patients and NSW ambulance data for people admitted to NSW hospitals with a diagnosis. of stroke.
Lead author Dr. Xia Wang, a researcher at the George Institute for Global Health, said that women typically have worse functional outcomes after stroke and require more supportive care than men, so it’s important to make sure that they receive the best care.
“Our study suggests that better recognition of stroke symptoms in women by ambulance staff could ensure that appropriate treatment is started as soon as possible and give them the best chance of recovery,” he said.
Stroke is the third most common cause of death in Australia, with 55,000 people likely to suffer one each year. Treatment is changing thanks to advances in medical research in recent years. There are now more proven options that lead to better outcomes for people who have had a stroke. But the success of these advances is often very time dependent, so it is critical to identify a stroke even before the patient has arrived at the hospital.
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More than 200,000 patients (51% women) admitted to hospitals in New South Wales between July 2005 and December 2018 and subsequently diagnosed with stroke were included in the study. Approximately half of the patients arrived at the hospital by ambulance, with women being more likely than men to present in this way.
The researchers found that women younger than 70 who were diagnosed with a stroke were more likely than men to be assessed by ambulance personnel as having a migraine, anxiety, loss of consciousness, high blood pressure, nausea or pain. head And they were less likely than men to receive prehospital stroke care during their ambulance ride. However, there was no difference in time between emergency call and admission to the emergency department.
Dr. Cheryl Carcel, a senior investigator and academic leader of the George Institute’s Global Brain Health Initiative, said that the underdiagnosis of stroke in women could be due to different symptoms, but that there was a possible implicit sex bias among the men. health care providers.
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“When stroke is not recognized early, delays can have serious consequences,” he said.
“Ambulance stroke care procedures ensure that patients with stroke symptoms are quickly taken to a high-level specialist center for life-saving treatment.
“While there are no studies looking at physician sex bias in stroke, we do have evidence from other countries where it is occurring in coronary artery disease. Greater awareness among all health professionals of the differences in symptom presentation between men and women could help address this bias,” said Dr. Carcel.
“In the case of a stroke, this is particularly important for ambulance staff so that women are identified early and treatment started even before they reach hospital.”