Sex Differences in Stroke Care and Outcomes: A National Stroke Registry Study

作者：Min Xu, Youssef Hbid, Kaili Stanley, Charles Wolfe, Matthew O’Connell, Abdel Douiri, Abby Cowey, Abdul Elmarimi, Adam Webber, Mrs Adele Griffiths, Hutchings Ailsa, Ailsa Miller, Ajoy Nair, Alakendu Sekhar, Alana Hunt, Alexandra Andrews, Alexandra Attwood, Alexandra Hunter, Alice Ramsey, Miss Alice Shale, Alison Beattie, Alison Stone, Alison Thomas, Alison Wootton, Allison Kandiah, Amanda Eddy, Amanda Edwards, Amanda Hulbert, Amanda Jones, Amulya Misra, Andrew Hill, Angela Dodd, Angela Keeney, Angela Kennedy, Angela Storey, Angie Logan, Anita Bailey, Anna Jillings, Anna Bahk, Anna Lovegrove, Anne Kettlewell, Ann‐Marie Clarke, Ann‐Marie Gaul, Anthony Dodds, Antonio Moreno Salmeron, Anu Thomas, Aoife Bennett, Bella Richard, Dr Benjamin Jelley, Bethan Griffiths, Bhairavi Shah, Barbara Holley, Breffni Keegan, Brian Clarke, Carly Broscombe, Callum Lloyd, Carly Adams, Carole Walters, Carolina De Campos, Caroline Thomas, Carrie Beaumont, Catherine Atkinson, Catherine McKenna, Catherine Roberts, Ceri Eady, Cerrys Parker, Charlotte Hall, Charlotte Cadman, Christina Connolly, Clair Finnemore, Claire Almond, Claire Crane, Claire Lee, Claire Quarterman, Claire Cook, Clare Fisher, Clare Holmes, Clare Mahon, Clare Rossiter, Clare Watson, Clare Webster, Clare Wilde, Claudia Bull, Conor Owain Martin, Corinne Stewart, Cristina Bayliss, Daisy Clark, David Eveson, David Mcfadden, David Rose, David Dean, David Hargroves, Deborah Angior, Debbie Bass, Debbie Heath, Deborah Ramsey, Derek Hilton, Dipti Mistry, Djamil Vahidassr, Don Sims, Donna Bayliss, Donna Berry, Donna Salt, Paul Davies, Edith Nhanga, Elizabeth Winterburn, Ehab Georgy, Elzbieta Tone, Eleanor Holman, Elizabeth Barnes, Emily Castle, Herne Bay, Emma Cork, Emma Davis, Emma Driver, Emma Griffiths, Emma Howarth, Emma Price, Fatima Hussain, Fiona Frith, Francesca Crew, Garry Jopling, Gauhar MaliK, Gavin Hughes, Gemma Edlin, Gemma Gumbley, Gemma Holden, Gemma Smith, Georgina Holt, Georgina Hughes, Georgina Simon, Georgina Walley, Giles Durward, Gillian Halstead, Gillian Horsey, Glynn Coupland, Graham Smith, Grainne O Hagan, Habib Rehman, Hannah Lyddon, Hannah Carr, Hannah Parrington, Harald Proeschel, Hardeep Baht, Hayley Vincent, Helen Crichton, Helen Ellis, Helen Whitbread, Hlaing Ni, Hollie Dhar, Holly Maguire, Hubert Sakkariyas, Ingrid Kane, Ijaz Anwar, Ishfaq Hussian, Ivan Vlahovic, Ivan Wiggam, Julie Bracken, Julia Gearhart, Mrs Janet Johnson, Jack Haines, Jackie Mason, Jacqui Quirke, Jagdish Kaswala, James Gilpin, James Newbury, James Scott, James White, Janet Clark, Janet Hornby, Janet Schmitt, Jayan Chembala, Jayne Cross, Jayne Thomas, Jeannine Johnson, Jennifer De Canha, Jessica Bagguley, Jessica Kubie, Jill Wright, James Kelly, Joanne Marshall, Jo Davidson, Jo Young, Joanna Kitchen, Jo Stevens, Joanne Ritchie, Joanne Wilson, Joanne Wise, Johanna Flaherty, John France, Jordi Morell, Jose Mabuti, Joseph Kwan, Judith Pie, Julia MacLeod, Julia Webster, Julia Browne, Kate Hellier, Ellie McMullen, Karen Robinson, Karl Jackson, Kate Levens, Kate Mattinson, Kate Cox, Katherine Mould, Kath Pasco, Katie Hinds, Katie Johnson, Katie Tomkins, Katrina Mitchell, Kausik Chatterjee, Kavita Shastri, Kelly Horton, Kelly O’Leary, Khalid Rashed, Khalil Kawafi, Kim Stimpson, Kim Warke, Kimberley Barker, Kirsten Nutman, Kirsty Jones, Kirubananthan Nagaratnam, Krina Bireh, Krishnamurthy Ganeshram, Kroot Kidson‐Petlem, Laurie Giraldo, Lankanatha Alwis, Lara Sands, Laura Fowler, Laura Shenton, Laura Martin, Liana Pretorius, Linda Thomson, Lindsay Ashman, Lisa Ellis, Lisa Maendl, Lisa Pearce, Lisa Penniall, Lisa‐Marie Cooke, Lizi Riley, Lorena Chua, Lorraine Boggis, Louisa Barratt, Louise Freemantle, Louise Johnson, Louise Southern, Louise Shaw, Lucy Allen, Lucy Boston, Lucy Holl, Lucy Rawlinson, Michael Haji‐Coll, Mohana Maddula, Maggie Cannon, Mair Carpenter, Malik Hussain, Maneesh Bhargava, Margaret Kirkland, Maria Espasandin, Mariusz Orlikowski, Mark Bowman, Mark Sudlow, Martin James, Matthew Burn, Meeta Pancholi, Melanie Blake, Michael Alcorn, Michael Magee, Michael Power, Michelle Hills‐Garner, Michelle Long, Michelle Magrath, Muhammad Khan, Mythreyi Mahadevan, Natalie Chaston, Natalie Holland, Natalie Townsend, Naveen Kishore Gadapa, Nicola Fletcher, Nia Williams, Nibu Thomas, Nicola Sweeting, Nicola Estabrook, Nicola Lorena, Nicola Utting, Niki Wyatt, Nicolette Ummatt, Nikhil Majmudar, Nikki Chadwick, Oluwatoyin Borishade, Omodoyinsola Ajibade, Paula Broomhead, Panagiotis Stergiou, Patricia White, Patrick Sutton, Paul Willcoxson, Paula Corrick, Penelope Fill, Peter Slade, Peter Sommerville, Phil Mathieson, Pippa Wright, Pratap Rana, Pratheesh Ravi, Ramanathan Kirthivasan, Raafat Farag, Rachel Marsh, Rachel Okin, Rachel Sibson, Raj Shekhar, Rajen Patel, Ramachandran Sivakumar, Ramamoorthy Nambi, Ramanand Palanichamy, Ravneeta Singh, Rebecca Emery, Rebecca Jewson, Rebecca Tyler, Rikki Tunesi, Rinta Peter Yuvaraj, Robert Downie, Robert Simister, Robert Luder, Rohan Pathansali, Roisin Healy, Ruhail Mir, Ruth Cutts, Amber Valley, Ruth Joy, Ruth Witham, Suja Cherian, Sofia Dima, Sarah Epps, Sai Sri Kanneganti, Sateeshwaran Palanisamy, Sophie Reading, Shehzadhusain Ugharadar, Sageet Amlani, Sajid Alam, Salah Elghenzai, Salwa Elmamoun, Samantha Campbell, Samantha Malkin, Samer Al Hussayni, Sara Betsworth, Sara Mazzucco, Sarah Coleman, Sarah Heathcote, Sarah Hunter, Sarah Rate, Sarah Theobalds, Sarah Hollands, Sara Millward, Saravan Thiru, Sarine Baz, Sean Brotheridge, Seemin Mahmood, Senthil Raghunathan, Sheeba Philip, Shivakumar Krishnamoorthy, Simon Crozier, Simon McBride, Sohil Jangra, Sonia Jenkinson, Sophie Turner, Susie Orme, Stephanie West, Stephen Morris, Stuart Maguire, Sukhi Aujla, Sunil Munshi, Sunoj Jacob, Sue Lee, Sushmita Mohapatra, Suzanne Ragab, Suzanne Williams, Suzy Butler, Syed Raza, Syed Tasneem Ahmad, Tak Ellis, Tara Lakin, Tasmin Nash, Terence Kelly, Terence Byrne, Thandar Soe, Thang Vu, Thom Luxon, Thomas Harrison, Toby Black, Tom Hughes, Touheed Parwaz, Udayaraj Umasankar, Ugnius Sukys, Vickie Yeardley, Veena James, Veronika Lechler, Vicki Pout, Vicki Steward, Vicky Jones, Vicky Lowrey, Victoria Williams, Yaqoob Bhat, Yvonne Hastings, Zoe Stephens‐Cross, Zuher Panju · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.124.040926 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Venous Thromboembolism Diagnosis and Management

BACKGROUND: Previous evidence on sex differences in stroke care and outcomes was limited in sample representativeness and coverage of care indicators. We aim to investigate various indicators of stroke care quality, survival, and functional outcome at discharge between men and women, using a national stroke registry. METHODS: Ten key indicators, representative from across stroke care pathway, were compared between men and women using the Sentinel Stroke National Audit Programme, a national quality register for England, Wales, and Northern Ireland (2013-2023, n=844 970). Multivariable Poisson regression models with robust variance were constructed to estimated adjusted relative risks (ARR). The 1-year adjusted hazard ratios (AHR) of mortality were conducted using adjusted restricted mean survival time. Favorable functional outcomes at discharge were measured using modified Rankin Scale (0-2). RESULTS: Women comprised 48% of the study population, mean age 77 years (SD: 13.4) compared with 72 years (13.3) for men. Compared with men, women tend to have severe strokes (19% versus 12%), lower prevalence of diabetes (20% versus 24%), and higher prevalence of atrial fibrillation (21% versus 18%) but similar stroke types (ischemic: 87% versus 88%). Women were less likely to have thrombolysis of arrival <1 hour, brain scan <1 hour, thrombolysis of stroke onset <4 hours, swallowing screen <4 hours, admission to stroke unit <4 hours, assessed by trained nurses <24 hours, assessed by occu...