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February 11, 2009Stroke

Quality of Care in Women With Ischemic Stroke in the GWTG Program

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Why the study?

Does female sex impact the quality of care and clinical outcomes in patients admitted for acute ischemic stroke?

Population

383,318 acute ischemic stroke admissions from 1,139 hospitals participating in the GWTG-Stroke program…

Comparison

Female sex vs Male sex

Design

Cohort

Follow-up

in-hospital

Key result

Female sex was associated with a lower likelihood of receiving defect-free care for acute ischemic stroke compared to male sex (66.3% vs 71.1%; aOR 0.86, 95% CI 0.85-0.87).

Authors

MRMathew J. ReevesGFGregg C. FonarowXZXin Zhao

Discussion

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Member takes

Overview

Hypothesis-generating for sex disparities in stroke care quality; prospective studies needed before guiding practice.

Study Design

Type

Observational (n=383,318)

Multicenter

Yes

Structured PICO

Does female sex impact the quality of care and clinical outcomes in patients admitted for acute ischemic stroke?

P
Population
383,318 acute ischemic stroke admissions from 1,139 hospitals participating in the GWTG-Stroke program between 2003 and 2008.
E
Exposure
Female sex
C
Comparator
Male sex
O
Outcome
Quality of care (measured using 7 predefined performance measures and a defect-free care summary measure), in-hospital mortality, and discharge homecomposite

Main Result

Odds Ratio: 0.86 (95% CI 0.85–0.87)

Absolute Event Rate: 66.3% vs 71.1%

Women with acute ischemic stroke receive lower quality of care and are less likely to be discharged home compared to men, despite similar risk-adjusted in-hospital mortality.

Cite This Study

Reeves et al. (2009) conducted an observational in acute ischemic stroke (n=383,318). Female sex vs. Male sex was evaluated on defect-free care summary measure (proportion of patients who received all eligible interventions) (aOR 0.86, 95% CI 0.85 to 0.87). Female sex was associated with a lower likelihood of receiving defect-free care for acute ischemic stroke compared to male sex (66.3% vs 71.1%; aOR 0.86, 95% CI 0.85-0.87).

synapsesocial.com/papers/6a221d833081c2f8f8e24398https://doi.org/10.1161/strokeaha.108.543157
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