Cool, Elena (2025) Advancing Stroke Equity: Female Sex as an Independent Predictor of Stroke Mimic Diagnosis, But Not of Reperfusion Therapy or Functional Outcome. thesis, Medicine.
Full text available on request.Abstract
Objective: This study aims to assess sex-based differences in stroke presentation, diagnosis, administration of treatment, and functional outcome. Background: Sex disparities in stroke have been increasingly recognized over recent years. Women are more likely to present with non-focal or atypical symptoms, contributing to a higher likelihood of stroke mimic diagnoses compared to men. Moreover, variations in the administration of treatment have been reported, which in turn, may affect functional outcomes. Methods: This retrospective cohort study included patients admitted to the Medisch Spectrum Twente (MST) with a suspected stroke between 2002 and now (n=14.237). Binary logistic regression analyzed the association between sex and the likelihood of receiving a stroke mimic diagnosis. Multinomial regression assessed the administration rate of reperfusion therapies on patients with ischemic stroke (n=9.203). Second binary logistic regression identified independent predictors of good functional outcome (mRS 0-2) at discharge. Results: Female sex remained independently associated with a higher likelihood of receiving a stroke mimic diagnosis, even after adjustment for confounders. In ischemic stroke patients, men were more likely to receive intravenous thrombolysis (IVT), though this difference lost significance after adjustment for confounders. Binary regression showed that sex was not an independent predictor of good functional outcome. The strongest predictors of a favorable outcome were lower stroke severity at admission and receiving combined IVT/IAT. Conclusion: Female sex is an independent predictor of a stroke mimic diagnosis, but not of the administration of reperfusion therapies or functional outcome. This study highlights notable sex differences in stroke in a Dutch cohort and underlines the need for continued research into the socio-cultural factors underlying these disparities.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Tuinman, drs. M.P. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Feb 2026 14:53 |
| Last Modified: | 23 Feb 2026 14:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3895 |
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