Utilization of intravenous tissue plasminogen activator for ischemic stroke: are there sex differences?

Published

Journal Article

BACKGROUND: We evaluated whether there were sex-related differences in the administration of intravenous tissue plasminogen activator (IV-tPA) to patients with acute ischemic stroke admitted to US academic medical centers. METHODS: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 academic medical centers from January through June, 2004, as part of the University HealthSystem Consortium Ischemic Stroke Benchmarking Project. Multivariate logistic models were used to test for sex-related differences in the receipt of IV-tPA with adjustment for demographic and clinical factors. RESULTS: The study included 1,234 patients (49% women; mean age 66.6 years; 56% white). IV-tPA was given to 7% (6.5% of women versus 7.5% of men, p = 0.49). Women and men were equally likely to receive IV-tPA in risk-adjusted analyses (OR 1.02, 95% CI 0.64-1.64). Approximately 77% of women and men who did not receive IV-tPA did not meet the 3-hour treatment window or their time of onset was unknown. CONCLUSIONS: Women admitted to academic hospitals receive IV-tPA as often as men; however, a substantial percentage of both women and men are not arriving within the 3-hour time window required for diagnostic assessment and administration of intravenous thrombolytic therapy. Additional efforts are needed to improve the rapid identification, evaluation and treatment of stroke patients.

Full Text

Duke Authors

Cited Authors

  • Allen, NB; Myers, D; Watanabe, E; Dostal, J; Sama, D; Goldstein, LB; Lichtman, JH

Published Date

  • 2009

Published In

Volume / Issue

  • 27 / 3

Start / End Page

  • 254 - 258

PubMed ID

  • 19176959

Pubmed Central ID

  • 19176959

Electronic International Standard Serial Number (EISSN)

  • 1421-9786

Digital Object Identifier (DOI)

  • 10.1159/000196824

Language

  • eng

Conference Location

  • Switzerland