1. Women patients with stroke were 10% less likely than male patients to achieve a door-to-computed tomography time (DTCT) within 25 minutes, the recommended time to prevent delayed treatments.
2. Black patients were 12% less likely, and Hispanic patients 7% more likely than white patients to achieve a DTCT within 25 minutes.
Evidence Rating Level: 2 (Good)
Stroke is a leading cause of morbidity and mortality, and there is a narrow time window for the gold standard treatment, intravenous tissue plasminogen activator, to be effective. The door-to-computed tomography time (DTCT) is an important indicator for timeliness of therapeutic interventions for stroke. It refers to the time from hospital arrival to brain CT imaging, which is ideally 25 minutes and under. Due to previous reports suggesting that there are disparities in stroke care amongst different sex and race-ethnic demographics, the current study investigated whether there are sex or race-ethnic disparities in DTCT. Data was collected from the Florida Stroke Registry, which included 93 Florida hospitals. The study population consisted of 63,265 records, 50% of whom were male, and with a mean (SD) age of 72 (14). The median DTCT was 22 minutes (interquartile range 32), and DTCT ≤ 25 was accomplished in 56% of patients. In terms of sex, the median DTCT was 21 minutes (IQR 34) and 23 minutes (IQR 36) in men and women respectively. For race, the median DTCT was lowest in White patients at 21 minutes (IQR 32), then Hispanic patients at 22 min. (IQR 32), followed by Black patients at 23 min. (IQR 37). As well, women patients and black patients with strokes were less likely to achieve DTCT ≤ 25 min. compared to male patients and white patients respectively (odds ratio 0.90, 95% CI 0.87-0.93; OR 0.88, 95% CI 0.84-0.94). Hispanic patients were more likely than white patients to achieve DTCT ≤ 25 min. (OR 1.07, 95% CI 1.01-1.14). Overall, this study demonstrated that discrepancies in DTCT for suspected stroke still exist between different sex and race-ethnic groups, with further research being pertinent for identifying the causes and reducing these disparities.
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