Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Gender Disparities in Stroke Code Activation in Patients with Intracerebral Hemorrhage
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
072
To identify factors associated with disparities in emergency department (ED) stroke code activation in a cohort of patients with intracerebral hemorrhage (ICH).
Systemic implementation of stroke codes results in timelier and more effective acute stroke management. However, it is unclear if differences in patient demographics lead to disparities in stroke code activation.
We identified consecutive patients with non-traumatic ICH who presented directly to our Comprehensive Stroke Center over 2 years. Demographics and ICH-related data were prospectively collected, while ED data on stroke code activation and clinical symptoms were retrospectively abstracted. We used multivariable logistic regression to examine differences in stroke code activation based on patient demographics (age, gender, race) while adjusting for initial clinical features (NIH Stroke Scale, FAST [facial drooping, arm weakness, speech difficulties] vs. non-FAST symptoms, time from last-known-well, and systolic blood pressure [SBP]).
Among 265 patients, 68% (n=179) had stroke code activation. Stroke codes occurred less frequently in women than men (62% vs. 72%, p=0.06) and in non-white vs. white patients (57% vs. 70%, p=0.08); age was similar between groups (mean±SD 72.3±15.2 vs. 69.9±15.1 years, p=0.24). Non-stroke code patients were less likely to have FAST symptoms (37% vs. 87%, p<0.001) and had lower initial SBP (mean±SD 159.3±34.2 vs. 176.0±31.9 mmHg, p<0.001) than stroke code patients. In multivariable models, neither age nor race were associated with stroke code activation. However, women were significantly less likely to have stroke codes than men (OR 0.50 [95% CI 0.25-0.99]), as were patients with non-FAST symptoms (OR 0.11 [95% CI 0.05-0.22]), while higher SBP conferred a higher likelihood of stroke code activation (OR 1.13 per 10 mmHg [95% CI 1.02-1.26]).
Our data suggest gender disparities in emergency stroke care that should prompt further investigations into potential systemic biases. Increased awareness of atypical stroke symptoms is also warranted. 
Authors/Disclosures
Savannah R. Doelfel (Brown University)
PRESENTER 		Ms. Doelfel has nothing to disclose.
No disclosure on file
Carlin Chuck Mr. Chuck has received personal compensation for serving as an employee of Brown University. Mr. Chuck has received research support from NIH (Grant: T35-HL094308).
No disclosure on file
No disclosure on file
Christoph Stretz, MD, FÂ鶹´«Ã½Ó³»­ (Brown University) The institution of Dr. Stretz has received research support from American Heart Association. The institution of Dr. Stretz has received research support from Duke University Medical Center/NIH. The institution of Dr. Stretz has received research support from University of Cincinnati/NINDS. The institution of Dr. Stretz has received research support from Biogen, Inc.. The institution of Dr. Stretz has received research support from Brown Physicians, Inc.. Dr. Stretz has a non-compensated relationship as a Editorial Board Member with Neurology: Clinical Practice that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Ali Mahta, MD (Brown University) Dr. Mahta has received research support from Brown University Health.
Linda C. Wendell, MD, FÂ鶹´«Ã½Ó³»­ (Mount Auburn Hospital) Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. An immediate family member of Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Wendell has stock in Apple. An immediate family member of Dr. Wendell has stock in Apple.
Bradford B. Thompson, MD (St. Elizabeth’s Medical Center) Dr. Thompson has nothing to disclose.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ) The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Tracy E Madsen No disclosure on file
Michael Reznik, MD (Rhode Island Hospital) Dr. Reznik has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Morrison Mahoney. The institution of Dr. Reznik has received research support from NIDUS.