Sex Differences in Screening for Large Vessel Occlusion and Thrombectomy: A Population-Based Cohort Study

Vollständiger Abstract

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BACKGROUND: Population-based sex differences in large vessel occlusion (LVO) screening and thrombectomy use for acute ischemic stroke are not well understood. We compared the detection of LVO, thrombectomy use, and long-term clinical outcomes in female versus male patients with cerebral ischemia in Ontario, Canada. METHODS: This retrospective cohort study used data from the Ontario Stroke Registry linked with health administrative data. We included adult patients hospitalized for cerebral ischemia within the first 24 hours of last seen normal time during 2 fiscal years (2019/2020 and 2022/2023). We used modified Poisson regression models to evaluate sex differences in intracranial neurovascular imaging, thrombolysis, or thrombectomy. Among patients with LVO, we used Cox proportional hazard and cause-specific hazard models to compare female versus male patients long-term mortality, readmission, or nursing home admission until 2025, stratified by thrombectomy treatment. RESULTS: Among 16 935 eligible patients (47% female patients; median age, 76 [interquartile range, 65–84] years), female patients were less likely than male patients to receive intracranial neurovascular imaging (83.6% female versus 87.8% male; P