title: Gender differences in emergency stroke care and hospital outcome in acute ischemic stroke: a multicenter observational study.
abstract: BACKGROUND
  We aimed to investigate the effect of gender difference on the accessibility to emergency care, hospital mortality and disability in acute stroke care.
  
  
  METHODS
  This study was performed on a single-tiered basic emergency medical service with a comprehensive national health insurance. Demographic variables, risk factors, elapsed time intervals, performing diagnosis and treatment options, hospital mortality, and modified Rankin Scale of acute ischemic stroke during 2008 were collected. We modeled the multivariate regression analysis for gender differences on the accessibility, hospital mortality, and disability. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated adjusting for potential risk factors.
  
  
  RESULTS
  The total number of patients was 6635. The time from symptom onset to emergency department (ED) arrival and to computed tomography or magnetic resonance imaging scan and from ED arrival to computed tomography or magnetic resonance imaging scan was significantly longer in women. No significant difference was found in either the time to intravenous thrombolysis or in the number of patients who received intravenous thrombolysis, anti-platelet therapy, anti-coagulation, or operation. The hospital mortality rate was higher in women (3.9%) than in men (2.9%) (P = .03). The increased disability was significantly higher in women (67.8%) than in men (65.1%) (P = .02). The hospital mortality and increased disability showed a non-significant difference between the 2 genders in the adjusted model (OR, 1.10; 95% CI, 0.74-1.64) and (OR, 1.11; 95% CI, 0.96-1.28), respectively.
  
  
  CONCLUSIONS
  The adjusted model for risk factors showed no significant difference on hospital mortality and disability between the 2 genders for stroke patients.
authors.affiliation: National Center for Mental Health Research and Education, Seoul National Hospital, Seoul, South Korea. satang95@daum.net
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.forename: Kyoung Jun
authors.initials: KJ
authors.lastname: Song
authors.forename: Juhwan
authors.initials: J
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000401:mortality* / Q000628:therapy*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility; D017052:Hospital Mortality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000401:mortality* / Q000628:therapy*; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome