Women and In-hospital Stroke Code Activation Age, Ethnicity, and Unique Symptoms Matter

Background Women have worse stroke outcomes than men, and almost 17% of all stroke cases have symptom onset when admitted to the hospital for a separate condition. Objective The aim of this study was to investigate the distinctive factors that impact the activation of an in-hospital stroke code and outcomes in women who have a stroke while admitted to the hospital for a separate condition. Methods A retrospective observational propensity score study guided by the model for nursing effectiveness was used. Results In-hospital stroke code was activated in 46 of 149 or 30.9% of women and 15 of 149 or 10.1% of women received thrombolytic therapy. Activation of an in-hospital stroke code was significant (P < .001) for women receiving thrombolytic therapy and significant to a home discharge status (P = .014). Age (P < .001), ethnicity (P < .001), common (P <= .001) and unique (P = .012) stroke symptoms, stroke risk factors (P < .001), comorbid conditions (P < .001), time last known well (P = .041), and diagnostic imaging (P < .001) were all significantly related to activation of an in-hospital stroke code. Conclusions Activation of an in-hospital stroke is a key indicator for women to receive thrombolytic therapy and be discharged to home. Younger married women from non-Caucasian ethnic groups and women with stroke risk factors and comorbid conditions are at a greater risk for delayed stroke symptom detection and not having an in-hospital stroke code activated. Awareness of these factors that hinder early stroke detection in women is crucial to improving stroke treatment and outcomes in women.

Automated summary

This study examines the factors impacting the activation of an in-hospital stroke code and outcomes in women who have a stroke while admitted for a separate condition. Results show that activation of an in-hospital stroke code is significant for women receiving thrombolytic therapy and being discharged to home. Various factors like age, ethnicity, stroke symptoms, risk factors, comorbid conditions, time last known well, and diagnostic imaging are related to the activation of in-hospital stroke code.