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Biological sex-dependent differences in acute and post-acute stroke care-a population-based case-control study.

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  • 1Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.

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|January 30, 2026
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Sex disparities in stroke care are minimal within a structured pathway. However, differences in diagnostics, mortality, and readmissions between men and women warrant further investigation for improved stroke treatment.

Keywords:
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Area of Science:

  • Neurology
  • Public Health
  • Health Services Research

Background:

  • Previous studies on sex disparities in stroke care relied on limited observational data.
  • A comprehensive analysis of the entire stroke treatment pathway is needed to understand sex-based differences.

Purpose of the Study:

  • To conduct a comprehensive analysis of sex-based disparities across the entire stroke care pathway.
  • To evaluate differences in stroke incidence, in-hospital care, and post-stroke outcomes between men and women.

Main Methods:

  • Utilized the quality-controlled, population-based Tyrolean Stroke Care pathway (2019-2023).
  • Analyzed data from all ischemic stroke cases, covering the entire patient journey from initial call to recurrent stroke re-hospitalization.
  • Adjusted for age, National Institute of Stroke Scale (NIHSS), and pre-stroke modified Rankin Scale (mRS).

Main Results:

  • 5733 ischemic stroke cases analyzed; men had a higher incidence of first stroke.
  • After adjustments, no significant differences in pre-hospital care or rehabilitation access were observed.
  • Women were less likely to be admitted to stroke units and undergo MRI/echocardiography but had fewer in-house complications.
  • Men showed higher all-cause mortality and recurrent stroke-related re-admission rates.

Conclusions:

  • Highly structured stroke care pathways minimize sex disparities in overall care.
  • Specific differences in diagnostic utilization, post-stroke mortality, and recurrent stroke rates between sexes require further research.
  • These findings highlight areas for targeted interventions to improve stroke care equity.