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Abstract W P227: Analysis of Gender and Time to Arrival Among Ischemic Stroke Patients in the Greater Cincinnati/ Northern Kentucky Stroke Study


 Background/ Purpose:
 Some studies of stroke patients report longer pre-hospital delays in women but vary in their inclusion of factors such as living situation and stroke severity. Other literature suggests gender differences in pre-hospital delays are more prominent in older age groups. The aim of our study was to investigate the relationship between gender and time to ED arrival and the influence of age and stroke severity on this relationship.
 
 
 Methods:
 Ischemic stroke patients ≥20 years old presenting to 16 area hospitals within a 5 county region of Greater Cincinnati/ Northern Kentucky during 2010 were included. Data on time from symptom onset to ED arrival and covariates were abstracted by study nurses and reviewed by study physicians. Data were analyzed using logistic regression with time to arrival dichotomized at ≤ 3 hours, overall and stratified by NIHSS and age categories.
 
 
 Results:
 2026 strokes (54% women, 22% black) were included. Time to arrival was not significantly different in women (geometric mean 335 minutes (95% CI 306 - 368) vs. 302 (95%CI 273 – 334), p =.14), and 24% of women vs. 27% of men arrived within 3 hours (p=0.20). More women lived alone (30% vs. 23%, p<.01). Women had a higher median age (74, IQR 60 - 84 vs. 67, IQR 57 – 79, p<.01) and were less likely to have mild stroke (NIHSS≤5) (67% vs. 74%, p<.01). Gender was not associated with delayed time to arrival (OR=1.00, 95%CI 0.79 - 1.27), after adjusting for age, NIHSS, race, insurance status, marital status, living situation, EMS use, pre-stroke mRS, wake-up stroke, night arrival, and prior stroke. Interactions between gender and age and gender and NIHSS were not significant. Those with NIHSS≤5 or who lived alone were less likely to arrive within 3 hours (Table).
 
 
 Conclusions:
 After adjusting for factors including age, NIHSS, and living alone, women and men with ischemic stroke had similar times to arrival. The relationship between gender and time to arrival did not change significantly across age or NIHSS categories.
 
 
 
