Sex differences in the evaluation and treatment of acute ischaemic stroke

被引：117

作者：

Bushnell, Cheryl ^{[1
]}

Howard, Virginia J. ^{[2
]}

Lisabeth, Lynda ^{[3
]}

Caso, Valeria ^{[4
]}

Gall, Seana ^{[5
]}

Kleindorfer, Dawn ^{[6
]}

Chaturvedi, Seemant ^{[7
]}

Madsen, Tracy E. ^{[8
]}

Demel, Stacie L. ^{[9
,10
]}

Lee, Seung-Jae ^{[11
]}

Reeves, Mathew ^{[12
]}

机构：

[1] Wake Forest Sch Med, Dept Neurol, Winston Salem, NC USA

[2] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA

[3] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA

[4] Univ Perugia, Santa Maria della Misericordia Hosp, Perugia, Italy

[5] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia

[6] Univ Cincinnati, Coll Med, Dept Neurol & Rehabil Med, Cincinnati, OH USA

[7] Univ Miami, Dept Neurol, Miami, FL USA

[8] Brown Univ, Dept Emergency Med, Alpert Med Sch, Providence, RI 02912 USA

[9] Michigan State Univ, Dept Neurol & Ophthalmol, E Lansing, MI 48824 USA

[10] Michigan State Univ, Pharmacol & Toxicol, E Lansing, MI 48824 USA

[11] Soonchunhyang Univ, Bucheon Hosp, Dept Neurol, Bucheon, South Korea

[12] Michigan State Univ, Dept Epidemiol, E Lansing, MI 48824 USA

来源：

LANCET NEUROLOGY | 2018年 / 17卷 / 07期

关键词：

TISSUE-PLASMINOGEN ACTIVATOR; EMERGENCY MEDICAL-SERVICE; HEALTH-CARE PROFESSIONALS; GENDER-DIFFERENCES; INTRAVENOUS THROMBOLYSIS; INTRAARTERIAL TREATMENT; ENDOVASCULAR TREATMENT; DIAGNOSTIC EVALUATION; SAFE IMPLEMENTATION; EXCLUSION CRITERIA;

D O I：

10.1016/S1474-4422(18)30201-1

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

With the greater availability of treatments for acute ischaemic stroke, including advances in endovascular therapy, personalised assessment of patients before treatment is more important than ever. Women have a higher lifetime risk of stroke; therefore, reducing potential sex differences in the acute stroke setting is crucial for the provision of equitable and fast treatment. Evidence indicates sex differences in prevalence and types of non-traditional stroke symptoms or signs, prevalence of stroke mimics, and door-to-imaging times, but no substantial differences in use of emergency medical services, stroke knowledge, eligibility for or access to thrombolysis or thrombectomy, or outcomes after either therapy. Women presenting with stroke mimics or non-traditional stroke symptoms can be misdiagnosed, which can lead to inappropriate triage, and acute treatment delays. It is essential for health-care providers to recognise possible sex differences in stroke symptoms, signs, and mimics. Future studies focused on confounders that affect treatment and outcomes, such as age and pre-stroke function, are also needed.

引用

页码：641 / 650

页数：10

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