title: Sex-related differences of acute stroke unit care: results from the Austrian stroke unit registry.
abstract: OBJECTIVE
  Sex-related differences in quality of acute stroke care are an important concern with limited data available, specifically regarding stroke unit (SU) setting. We used the prospective nationwide Austrian SU registry to address this issue.
  
  
  METHODS
  Our analysis covered an 8-year time period (January 2005 to December 2012) during which all patients with transient ischemic attack or ischemic stroke admitted to 1 of 35 Austrian SU had been captured in the registry. These data were analyzed for age-adjusted preclinical and clinical characteristics and quality of acute stroke care in men and women. In addition, we assessed the outcome at 3 months in multivariate analysis.
  
  
  RESULTS
  A total of 47 209 individuals (47% women) had received SU care. Women were significantly older (median age: 77.9 versus 70.3 years), had higher pre-existing disability and more severe strokes. Correcting for age, no significant sex-related differences in quality of care were identified with comparable onset-to-door times, times to and rates of neuroimaging, as well as door-to-needle times and rates of intravenous thrombolysis (14.5% for both sexes). Despite equal acute stroke care and a comparable rate of neurorehabilitation, women had a worse functional outcome at 3-month follow-up (modified Rankin scale 3-5: odds ratio, 1.26; 95% confidence interval [1.17-1.36]), but a lower mortality (odds ratio, 0.70; 95% confidence interval [0.78-0.88]) after correcting for confounders.
  
  
  CONCLUSIONS
  We identified no disproportions in quality of care in the acute SU setting between men and women, but the outcome was significantly different. Further studies on the poststroke period including socioeconomic aspects are needed to clarify this finding.
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Gattringer
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Julia
authors.initials: J
authors.lastname: Ferrari
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Michael
authors.initials: M
authors.lastname: Knoflach
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Leonhard
authors.initials: L
authors.lastname: Seyfang
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Susanna
authors.initials: S
authors.lastname: Horner
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Kurt
authors.initials: K
authors.lastname: Niederkorn
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Valeriu
authors.initials: V
authors.lastname: Culea
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Markus
authors.initials: M
authors.lastname: Beitzke
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Wilfried
authors.initials: W
authors.lastname: Lang
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.).
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: From the Department of Neurology (T.G., S.H., K.N., V.C., M.B., C.E., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz, Graz, Austria; Department of Neurology, Hospital Barmherzige Brueder, Vienna, Austria (J.F., W.L.); Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M.K.); and Center of Clinical Neurosciences, Danube University of Krems, Krems, Austria (L.S.). franz.fazekas@medunigraz.at.
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D002545:Brain Ischemia / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012727:Sex Characteristics; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy
keywords: ischemic attack, transient; ischemic stroke; sex