Sex and Race-Ethnic Disparities in Door-to-CT Time in Acute Ischemic Stroke: The Florida Stroke Registry.
Aged
Delayed Diagnosis
/ adverse effects
Ethnicity
Female
Fibrinolytic Agents
/ administration & dosage
Florida
/ epidemiology
Healthcare Disparities
/ ethnology
Hospitalization
/ statistics & numerical data
Humans
Ischemic Stroke
/ diagnosis
Male
Outcome and Process Assessment, Health Care
Quality Improvement
/ organization & administration
Registries
/ statistics & numerical data
Sex Factors
Time-to-Treatment
/ standards
Tissue Plasminogen Activator
/ administration & dosage
Tomography, X-Ray Computed
/ methods
disparities
ethnicity
ischemic stroke
race
sex
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
06 04 2021
06 04 2021
Historique:
pubmed:
1
4
2021
medline:
26
10
2021
entrez:
31
3
2021
Statut:
ppublish
Résumé
Background Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry). Methods and Results Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator-treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87-0.93) and Black (OR, 0.88; CI, 0.84-0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01-1.14), to achieve DTCT ≤25. In a secondary analysis among intravenous tissue plasminogen activator-treated patients, 81% of patients achieved DTCT ≤25. In this subgroup, women were less likely to receive DTCT ≤25 (0.85, 0.77-0.94) whereas no significant differences were observed by race or ethnicity. Conclusions In the FSR, there was considerable improvement in acute stroke care metric DTCT ≤25 in 2018 in comparison to 2010. However, sex and race-ethnic disparities persist and require further efforts to improve performance and reduce these disparities.
Identifiants
pubmed: 33787282
doi: 10.1161/JAHA.120.017543
pmc: PMC8174374
doi:
Substances chimiques
Fibrinolytic Agents
0
Tissue Plasminogen Activator
EC 3.4.21.68
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e017543Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR000461
Pays : United States
Organisme : NINDS NIH HHS
ID : U54 NS081763
Pays : United States
Organisme : NIMHD NIH HHS
ID : R01 MD012467
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS084288
Pays : United States
Organisme : NINDS NIH HHS
ID : U24 NS107267
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS029993
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS040807
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002736
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR002737
Pays : United States
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