TY - JOUR
T1 - Differences in the pre-hospital management of women and men with stroke by emergency medical services in New South Wales
AU - Wang, Xia
AU - Carcel, Cheryl
AU - Hsu, Benjumin
AU - Shajahan, Sultana
AU - Miller, Matthew
AU - Peters, Sanne
AU - Randall, Deborah A.
AU - Havard, Alys
AU - Redfern, Julie
AU - Anderson, Craig S.
AU - Jorm, Louisa
AU - Woodward, Mark
N1 - Publisher Copyright:
© 2022 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objectives: To examine whether pre-hospital emergency medical service care differs for women and men subsequently admitted to hospital with stroke. Design, setting, participants: Population-based cohort study; analysis of linked Admitted Patient Data Collection and NSW Ambulance data for people admitted to New South Wales hospitals with a principal diagnosis of stroke at separation, 1 July 2005 – 31 December 2018. Main outcome measures: Emergency medical service assessments, protocols, and management for patients subsequently diagnosed with stroke, by sex. Results:Of 202 231 people hospitalised with stroke (mean age, 73 [SD, 14] years; 98 599 women [51.0%]), 101 357 were conveyed to hospital by ambulance (50.1%). A larger proportion of women than men travelled by ambulance (52.4% v 47.9%; odds ratio [OR], 1.09; 95% CI, 1.07–1.11), but time between the emergency call and emergency department admission was similar for both sexes. The likelihood of being assessed as having a stroke (adjusted OR [aOR], 0.97; 95% CI, 0.93–1.01) or subarachnoid haemorrhage (aOR, 1.22; 95% CI, 0.73–2.03) was similar for women and men, but women under 70 years of age were less likely than men to be assessed as having a stroke (aOR, 0.89; 95% CI, 0.82–0.97). Women were more likely than men to be assessed by paramedics as having migraine, other headache, anxiety, unconsciousness, hypertension, or nausea. Women were less likely than men to be managed according to the NSW Ambulance pre-hospital stroke care protocol (aOR, 0.95; 95% CI, 0.92–0.97), but the likelihood of basic pre-hospital care was similar for both sexes (aOR, 1.01; 95% CI, 0.99–1.04). Conclusion:Our large population-based study identified sex differences in pre-hospital management by emergency medical services of women and men admitted to hospital with stroke. Paramedics should receive training that improves the recognition of stroke symptoms in women.
AB - Objectives: To examine whether pre-hospital emergency medical service care differs for women and men subsequently admitted to hospital with stroke. Design, setting, participants: Population-based cohort study; analysis of linked Admitted Patient Data Collection and NSW Ambulance data for people admitted to New South Wales hospitals with a principal diagnosis of stroke at separation, 1 July 2005 – 31 December 2018. Main outcome measures: Emergency medical service assessments, protocols, and management for patients subsequently diagnosed with stroke, by sex. Results:Of 202 231 people hospitalised with stroke (mean age, 73 [SD, 14] years; 98 599 women [51.0%]), 101 357 were conveyed to hospital by ambulance (50.1%). A larger proportion of women than men travelled by ambulance (52.4% v 47.9%; odds ratio [OR], 1.09; 95% CI, 1.07–1.11), but time between the emergency call and emergency department admission was similar for both sexes. The likelihood of being assessed as having a stroke (adjusted OR [aOR], 0.97; 95% CI, 0.93–1.01) or subarachnoid haemorrhage (aOR, 1.22; 95% CI, 0.73–2.03) was similar for women and men, but women under 70 years of age were less likely than men to be assessed as having a stroke (aOR, 0.89; 95% CI, 0.82–0.97). Women were more likely than men to be assessed by paramedics as having migraine, other headache, anxiety, unconsciousness, hypertension, or nausea. Women were less likely than men to be managed according to the NSW Ambulance pre-hospital stroke care protocol (aOR, 0.95; 95% CI, 0.92–0.97), but the likelihood of basic pre-hospital care was similar for both sexes (aOR, 1.01; 95% CI, 0.99–1.04). Conclusion:Our large population-based study identified sex differences in pre-hospital management by emergency medical services of women and men admitted to hospital with stroke. Paramedics should receive training that improves the recognition of stroke symptoms in women.
UR - http://www.scopus.com/inward/record.url?scp=85133939040&partnerID=8YFLogxK
U2 - 10.5694/mja2.51652
DO - 10.5694/mja2.51652
M3 - Article
C2 - 35831059
AN - SCOPUS:85133939040
SN - 0025-729X
VL - 217
SP - 143
EP - 148
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 3
ER -