Evidence map›Paper›PMID 37802001›Full record

ArticleThe American journal of emergency medicine2023

Sex differences in acute ischemic stroke presentation are a matter of infarct location.

Hannah M Higgins, Lucia Chen, Brandy C Ravare, Kerri A Jeppson, Heather T Bina, Paco S Herson, Andrew A Monte, Sharon N Poisson, Layne Dylla

Open access · greenAbstract read
In one paragraph

Article in The American journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Hannah M HigginsDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America.
Lucia ChenDepartment of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Brandy C RavareDepartment of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Kerri A JeppsonDepartment of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Heather T BinaDepartment of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Paco S HersonDepartment of Neurological Surgery, The Ohio State University, College of Medicine, Columbus, OH, United States of America.
Andrew A MonteDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America.
Sharon N PoissonDepartment of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Layne DyllaDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America. Electronic address: Layne.Dylla@cuanschutz.edu.
University of Colorado Denver · USNeurological Surgery · US

Funding

NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
Colorado Clinical and Translational Sciences Institute (CCTSI)UM1TR004399 · NCATS · UNIVERSITY OF COLORADO DENVER · PI JANINE A HIGGINS, RONALD J. SOKOL · 2023 to 2026
$30.7M
UCHSC: Building Interdisciplinary Research Careers in Women's HealthK12HD057022 · NICHD · UNIVERSITY OF COLORADO DENVER · PI REGENSTEINER, JUDITH G., SANTORO, NANETTE F. · 2007 to 2023
$8.5M
The Colorado Building Interdisciplinary Research Careers in Women's Health ProgramK12AR084226 · NIAMS · UNIVERSITY OF COLORADO DENVER · PI JUDITH G. REGENSTEINER, Nanette F. Santoro · 2023 to 2026
$2.5M
PERSONALIZING EMERGENCY/ACUTE THERAPEUTICS UTILIZING SYSTEMS BIOLOGY (PEGASUS)R35GM124939 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI MONTE, ANDREW ALBERT · 2017 to 2021
$2.1M
Personalizing EmerGency/Acute therapeuticS Utilizing Systems biology (PEGASUS-2)R35GM152157 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI Andrew Albert Monte · 2024 to 2026
$1.2M
NCATS NIH HHS UL1 TR002535NCATS NIH HHS UM1 TR004399NIAMS NIH HHS K12 AR084226NICHD NIH HHS K12 HD057022NIGMS NIH HHS R35 GM124939NIGMS NIH HHS R35 GM152157
6 · The paper itself

Abstract

introductionRecognition of stroke by Emergency Medical Services (EMS) is critical to initiate rapid emergency department treatment. Most prehospital stroke screening tools rely heavily on presentation with the classic symptoms of facial droop, speech changes, unilateral weakness. However, women may be less likely to present with classic symptoms and may also have different distributions of stroke by anatomical location. This study seeks to determine the association between biological sex, presentation with classic symptoms, and the location of the infarcted tissue.

methodsThis is a retrospective cohort study. Data from electronic health records were extracted for patients with acute ischemic stroke who presented via EMS to a single Comprehensive Stroke Center between January 1, 2018 and December 31, 2020. We used descriptive statistics characterize the cohort. Multivariable logistic regression identified factors associated with classic symptom presentation (facial droop, speech changes, and/or unilateral weakness). Biological sex, location of the infarct, stroke etiology, age and the interaction between sex and infarct location were assessed as covariates.

resultsThere were 364 (58.6%) males and 257 (41.1%) females with an acute ischemic stroke included in this study. EMS documented one or more classic symptoms in 125 (72.3%) males and 161 (67.9%) females. There were no baseline differences in infarct location or presentation with classic symptoms as documented by EMS comparing males and females. Multivariate logistic regression found no association between biological sex and presentation with classic symptoms (Odds Ratio 1.08; 95% CI 0.58 to 1.55) after controlling for age, stroke location, etiology of stroke or the interaction between sex and infarct location. Presence of an anterior circulation infarct compared to posterior circulation infarct was positively associated with a classic presentation to EMS (Odds Ratio 3.41; 95% CI 2.15 to 5.41).

conclusionsThis study found no difference in the frequency of patient presentation with classic stroke symptoms based on biological sex alone, nor a significant different in distribution of infarcts between males and females. Infarct location (i.e., involving the anterior circulation) was associated with a classic presentation. This suggests that the likelihood of presenting with classic stroke symptoms is not influenced by sex, but rather the location of the infarct.

Indexed as

Brain IschemiaIschemic StrokeStrokeFemaleHumansInfarctionMaleRetrospective StudiesSex CharacteristicsCerebrovascular accidentIschemic strokeSex disparitiesStroke

Identifiers

PMID37802001
PMCPMC10843056
OpenAlexW4387122342

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.