HEALTHCARE INSTITUTIONAL SEXISM, MISOGYNY 

Women less likely than men to receive opportune care after stroke, study finds

Reports and Proceedings

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

Women are less likely than men to receive timely care for strokes caused by blockages in large vessels, known as emergent large vessel occlusion (ELVO), according to researchers with The University of Texas Health Science Center at Houston (UTHealth).

The study, “Women with Large Vessel Occlusion Acute Ischemic Stroke Are Less Likely to Be Routed to Comprehensive Stroke Centers,” was presented today at the Society of NeuroInterventional Surgery’s 18th Annual Meeting.

ELVO is caused by a blockage in a large vessel in the brain, cutting off significant blood flow. The most effective treatment to help prevent long-term disabilities from the stroke is a thrombectomy, a minimally invasive procedure that uses catheters to reopen blocked arteries in the brain.

“Many of the women who suffer emergent large vessel occlusion ischemic strokes are not being routed to the appropriate setting where they can get the most effective treatment,” said Muhammad Tariq, MD, the study’s author and a neurology resident with McGovern Medical School at UTHealth. “These patients should be sent to comprehensive stroke centers, where the care team specializes in treating strokes and preventing further damage.”  

Comprehensive stroke centers have the expertise to perform thrombectomies and other treatments not available in primary stroke centers.

Researchers analyzed data from 10 stroke centers to determine which patients experiencing an ELVO were routed directly to comprehensive stroke centers to receive more intensive care.  

Of 490 patients who suffered an ELVO, women made up nearly half (46%) of the total and were nearly 11% less likely to be taken to a comprehensive stroke center, while 90% of the men who suffered an ELVO were routed directly to these centers.

“Women who suffer a stroke, not limited to an emergent large vessel occlusion ischemic stroke, have been identified to receive less stroke treatment,” said Youngran Kim, PhD, author on the study and postdoctoral research fellow in the Department of Neurology at McGovern Medical School. “A potential explanation for this difference could include failure to recognize stroke symptoms, which delays women in seeking care. Additionally, women who suffer a stroke tend to be older and may be frailer. Studies also show that women are more likely to present with ‘nontraditional’ stroke symptoms, such as fatigue, weakness, disorientation, and mental status change.”

“My hope is that by presenting these results, we can help providers understand that we need to work to bridge the gender gap in health care,” said Tariq, who sees patients with UTHealth Neurosciences, a clinical practice of McGovern Medical School. “There are already existing routing mechanisms to ensure that patients receive the best care for their chance at survival and recovery. I hope we can open up the conversation to show that there are patients who should be getting this treatment, but are actually not getting the help quick enough.”

Memorial Hermann-Texas Medical Center, the teaching hospital of UTHealth, is recognized by The Joint Commission and the American Heart Association/American Stroke Association as a comprehensive stroke center. It is the first Stroke Center in Houston and one of the first dedicated stroke programs in the world.

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