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- W2914896241 abstract "Introduction: Sex differences have been found in stroke risk factors, incidence, treatment, and outcomes. There are conflicting data on whether diagnostic evaluation for stroke may differ between men and women. Methods: We performed a retrospective cohort study using inpatient and outpatient claims between 2008-2015 from a nationally representative 5% sample of Medicare beneficiaries. We included patients who were ≥65 years old and hospitalized with ischemic stroke, defined by validated ICD-9-CM diagnosis codes. Medicare providers’ specialty codes, National Provider Identifier numbers, and data from the American Board of Psychiatry and Neurology were used to determine which patients were evaluated by a neurologist or vascular neurologist during their index stroke hospitalization or within 90 days of discharge. CPT codes were used to ascertain whether intracranial vessel imaging, cervical vessel imaging, echocardiography, and heart-rhythm monitoring were performed during the same period. Logistic regression was used to determine the association between female sex and the odds of diagnostic testing and specialist evaluation after adjustment for age, race, and number of Charlson comorbidities. Results: Of 66,989 patients with ischemic stroke, 58.4% (95% CI, 58.1-58.8%) were female. After adjustment for age, race, and comorbidities, female sex was associated with decreased odds of intracranial vessel imaging (OR, 0.94; 95% CI, 0.91-0.97), cervical vessel imaging (OR, 0.90; 95% CI, 0.87-0.93), heart-rhythm monitoring (OR, 0.92; 95% CI, 0.86-0.98), echocardiography (OR, 0.92; 95% CI, 0.89-0.95), evaluation by a non-vascular neurologist (OR, 0.95; 95% CI, 0.92-0.99), and evaluation by a vascular neurologist (OR, 0.94; 95% CI, 0.90-0.98). Our findings were unchanged in sensitivity analyses excluding patients who died during the index hospitalization or patients discharged to hospice. Conclusions: In a nationally representative cohort of Medicare beneficiaries, we found that women with ischemic stroke were less likely to be evaluated by stroke specialists and less likely to undergo standard diagnostic testing compared to men." @default.
- W2914896241 created "2019-02-21" @default.
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- W2914896241 date "2019-02-01" @default.
- W2914896241 modified "2023-10-14" @default.
- W2914896241 title "Abstract WMP66: Differences in Diagnostic Evaluation in Women and Men After Acute Ischemic Stroke" @default.
- W2914896241 doi "https://doi.org/10.1161/str.50.suppl_1.wmp66" @default.
- W2914896241 hasPublicationYear "2019" @default.
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