Study Finds Women With ELVO Are 11% Less Likely Than Men to Be Sent to Level 1 Stroke Centers

July 29, 2021—The Society of NeuroInterventional Surgery (SNIS) announced findings from a study suggesting that women may be less likely than men to get timely care for emergent large vessel occlusion (ELVO) ischemic strokes.

The study, “Women with Large Vessel Occlusion Acute Ischemic Stroke Are Less Likely to Be Routed to Comprehensive Stroke Centers,” was presented at the SNIS 18th annual meeting held July 26-30 in Colorado Springs, Colorado.

The study investigators reviewed 1.5 years of data from 10 stroke centers to determine which patients experiencing an ELVO were routed directly to comprehensive—level 1—stroke centers to receive thrombectomy. Level 1 stroke centers, noted SNIS, have the most comprehensive services, including a specially trained neurointerventional care team that is available to treat strokes 24/7/365. By contrast, primary stroke centers may not have round-the-clock stroke surgery capability, may not have a specialized intensive care unit for stroke patients, and may need to transfer the most complex patients to level 1 stroke centers.

As summarized by SNIS, the study was composed of 490 patients (female, 46%) with ELVO. Stroke severity, travel distances to level 1 stroke centers, and comorbidities were similar between women and men, although women were older than men (median age, 73 years vs 65 years).

Whereas approximately 90% of male patients with ELVO were routed directly to level 1 stroke centers, significantly lower rates were observed in women. After accounting for differences in stroke type, patient age, travel distance, and other relevant factors, women with ELVO were approximately 11% less likely to be taken to a level 1 stroke center compared to men.

Sunil Sheth, MD, Assistant Professor of Neurology at McGovern Medical School at The University of Texas Health Science Center at Houston, Texas, is the lead author of the study.

“It’s essential that all patients with ELVO ischemic strokes receive urgent care for this condition in the most appropriate setting,” commented Dr. Sheth in the SNIS press release. “At state and regional levels around the nation, we have built prehospital routing programs to ensure that patients with this type of stroke are taken directly to the appropriate hospitals. This study shows that we need to work harder to bridge the gender health care gap and ensure that all patients who need stroke surgery are routed to the right hospital for the best chance of survival, recovery, and independence.”