Sex Disparities in Prehospital and In-Hospital Delays to Intravenous Thrombolysis in Egyptian Stroke Patients.
Neuroepidemiology · 2026-01-22 · Observational study
Abstract
UNLABELLED: Introduction and Aim of the Work: Numerous studies have shown contradictory data regarding sex differences in pre- and in-hospital delays of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). Our objective was to investigate these differences among Egyptian patients presenting with AIS. METHODS: This prospective, single-center, open-label cohort study was conducted from September 2022 to December 2023. Patients with IVT-eligible AIS, who did not receive IVT, were included in the study. Patients were recruited from the largest tertiary stroke center in the south of Egypt. All participants underwent a full neurological assessment including NIHSS, laboratory workup, and computed tomography or magnetic resonance imaging. The patients were subjected to a structured questionnaire designed to determine the parameters and time metrics associated with prehospital and in-hospital delays. RESULTS: A total of 897 patients, 41.8% of whom were females, were included in our study. General demographic characteristics were similar between both groups. A total of 70.9% of female patients and 65.1% of male patients arrived at stroke-ready hospital outside the therapeutic time window. Female patients experienced a significantly longer duration from symptom onset to hospital arrival (600 ± 618 min) compared to male patients (480 ± 438 min). Stroke misdiagnosis was nonsignificantly higher among the female group (58.9%). The time spent in the hospital did not significantly differ between males and females. CONCLUSION: The study results indicate a significant disparity in the management of female stroke patients in both prehospital and in-hospital settings, with the most pronounced delays occurring during prehospital care.