A recent study has highlighted a significant gender disparity in the identification of strokes by paramedics, revealing that women are less likely to have their strokes recognized compared to men. This discrepancy in diagnosis can have critical implications for treatment and recovery, as timely intervention is crucial in stroke cases.
Strokes occur when the blood supply to part of the brain is interrupted, either due to a blockage, known as an ischaemic stroke, or bleeding, referred to as a haemorrhagic stroke. Ischaemic strokes account for approximately 83% of all cases. The primary emergency treatment for ischaemic strokes is intravenous thrombolysis, a “clot-busting” procedure that is most effective if administered swiftly—ideally within an hour of hospital arrival and no later than 4.5 hours after the onset of symptoms. Prompt treatment significantly enhances survival and recovery prospects.
However, research indicates that not everyone receives equal access to this urgent care. A recent study has shown that ambulance staff are significantly less likely to correctly identify strokes in women compared to men. This finding underscores a critical gap in emergency medical response that could have life-altering consequences.
The Sex Gap in Stroke Diagnosis
In Australia, approximately three-quarters of stroke patients are transported to the hospital by ambulance. When paramedics suspect a stroke, they can expedite care by taking patients directly to specialized stroke centers and alerting hospital teams to prepare for immediate intervention. Despite these protocols, research reveals that women under 70 are 11% less likely than men to have their strokes identified by paramedics before reaching the hospital.
While younger men and women experience strokes at similar rates, they often present with different symptoms. Men are more likely to exhibit “typical” stroke symptoms, whereas women frequently show “atypical” symptoms such as general weakness, changes in alertness, or confusion. These atypical symptoms can be easily overlooked, leading to misdiagnosis, delayed treatment, and preventable harm.
Research Findings and Implications
The study, recently published in the Medical Journal of Australia (MJA), utilized ambulance and hospital data from a 2022 study in New South Wales. This research confirmed that paramedics more accurately identified strokes in men than in women under 70. The researchers analyzed data from over 5,500 women under 70 who experienced ischaemic strokes between 2005 and 2018, constructing a model to compare current diagnostic rates with an improved scenario where women’s strokes are identified at the same rate as men’s.
Improving women’s stroke diagnosis rates to match men’s could result in each woman gaining an average of 0.14 extra years of life (approximately 51 days) and 0.08 extra quality-adjusted life years (QALYs), equating to an additional 29 days in full health. This adjustment could save A$2,984 in healthcare costs per woman.
On a national scale, closing this diagnostic gap could translate to 252 extra years of life, 144 additional QALYs, and $5.4 million in annual cost savings.
Addressing the Disparity
The disparity in stroke diagnosis is indicative of a broader systemic issue in women’s health, where sex-based differences in diagnosis and treatment often favor men. Women’s symptoms are frequently misinterpreted or dismissed when they do not align with “typical” patterns, leading to delays and missed opportunities for early treatment.
To address this gap, investing in enhanced training for paramedics and emergency responders to recognize a wider range of stroke presentations could yield significant benefits. Public awareness campaigns that emphasize atypical stroke symptoms could also play a crucial role. Additionally, technologies such as mobile stroke units and telemedicine support, if implemented with attention to sex-specific needs, could contribute to more equitable healthcare outcomes.
This article is republished from The Conversation under a Creative Commons license. Read the original article by Lei Si, Associate Professor in Health Services Management at Western Sydney University; Laura Emily Downey, Senior Lecturer in Health Economics and Policy at the George Institute for Global Health; and Thomas Gadsden, Research Fellow in Health Systems Science at the George Institute for Global Health.
