Abstract Body: Background: Stroke is a leading cause of death and disability globally, with timely intervention being critical to improving patient outcomes. Tele-stroke networks have been developed to bridge the gap in stroke expertise, particularly in rural areas where multidisciplinary stroke care is scarce. This study aims to compare stroke outcomes between male and female patients within a large tele-stroke network.
Methods: We conducted a retrospective analysis of 7,947 patients who were evaluated for acute ischemic stroke symptoms via a tele-stroke network encompassing a hub and 38 spoke centers. Baseline characteristics, treatment details, and outcomes were compared between male (n=3,513) and female (n=4,434) patients. Statistical analyses included Chi-square tests for categorical data and Mann-Whitney U tests for continuous variables, with a significance threshold of p < 0.05.
Results: The median age was significantly higher in females (70 years, IQR: 55-82) compared to males (66 years, IQR: 56-78) (p < 0.001). True stroke diagnosis was more prevalent in males (82.4%) than females (80.2%) (p = 0.01). The recommendation for tissue plasminogen activator (tPA) was similar between genders (p = 0.08), but males were more likely to receive tPA (14.7%) compared to females (13%) (p = 0.05). Mechanical thrombectomy was performed in 2.3% of patients with no significant difference between genders (p = 0.96). The median time from last known normal to tPA administration was slightly longer in males (120 minutes) compared to females (107.5 minutes) (p = 0.17). Hemorrhagic transformation occurred in 8.2% of patients, with no significant gender differences. The median length of hospital stay was 4 days for both genders, and the NIHSS score at discharge showed no significant difference (p = 0.93).
Conclusion: Our study highlights subtle yet important differences in stroke treatment outcomes between male and female patients within a tele-stroke network. While tPA administration was more common in males, the overall outcomes, including the length of stay and NIHSS at discharge, were similar between genders. These findings highlight the importance of individualized treatment approaches in stroke care, particularly in the context of telemedicine, where rapid decision-making is vital.