Have transformed acute stroke care in recent years. Landmark trials of intravenous thrombolysis The implications: Refining the assessment of symptoms in women in pre‐hospital emergency services care could improve patient outcomes. Among people under 70, women with stroke were more likely than men to be diagnosed by paramedics with conditions other than stroke. The new: Women subsequently admitted to hospital with stroke were more likely than men to arrive by ambulance, but less likely to receive stroke‐specific management during their journey. Investigations of sex differences in pre‐hospital emergency medical service care for people with stroke have yielded inconsistent results. The known: Stroke‐related disability is greater for women than men, and their subsequent quality of life poorer. Women were less likely than men to be managed according to the NSW Ambulance pre‐hospital stroke care protocol (aOR, 0.95 95% CI, 0.92–0.97), but the likelihood of basic pre‐hospital care was similar for both sexes (aOR, 1.01 95% CI, 0.99–1.04). Women were more likely than men to be assessed by paramedics as having migraine, other headache, anxiety, unconsciousness, hypertension, or nausea. The likelihood of being assessed as having a stroke (adjusted OR, 0.97 95% CI, 0.93–1.01) or subarachnoid haemorrhage (aOR, 1.22 95% CI, 0.73–2.03) was similar for women and men, but women under 70 years of age were less likely than men to be assessed as having a stroke (aOR, 0.89 95% CI, 0.82–0.97). A larger proportion of women than men travelled by ambulance (52.4% v 47.9% odds ratio, 1.09 95% CI, 1.07–1.11), but time between the emergency call and emergency department admission was similar for both sexes. Of 202 231 people hospitalised with stroke (mean age, 73 years 98 599 women ), 101 357 were conveyed to hospital by ambulance (50.1%).
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