Madsen Tracy E, Roberts Eric T, Kuczynski Heather, Goldmann Emily, Parikh Nina S, Boden-Albala Bernadette
Alpert Medical School of Brown University, Providence, Rhode Island.
College of Global Public Health, New York University, New York, New York.
J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2734-2741. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.046. Epub 2017 Aug 12.
The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset.
As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center. Logistic regression was conducted with arrival to the ED ≤3 hours as the outcome, social network characteristics as explanatory variables, and gender as a potential effect modifier.
Men who lived alone or were divorced were significantly less likely to arrive ≤3 hours than men who lived with a spouse (adjusted odds ratio [aOR]: .31, 95% confidence interval [CI]: .15-0.64) or were married (aOR: .45, 95% CI: .23-0.86). Among women, those who lived alone or were divorced had similar odds of arriving ≤3 hours compared with those who lived with a spouse (aOR: 1.25, 95% CI: .63-2.49) or were married (aOR: .73, 95% CI: .4-1.35).
In patients with stroke/TIA, living with someone or being married improved time to arrival in men only. Behavioral interventions to improve stroke preparedness should incorporate gender differences in how social networks affect arrival times.
本研究旨在探讨性别对社交网络与卒中准备之间关联的影响，卒中准备通过症状发作后3小时内到达急诊科（ED）来衡量。
作为卒中预警信息与更快治疗研究的一部分，从哥伦比亚大学医学中心前瞻性纳入的1193例卒中/短暂性脑缺血发作（TIA）患者中收集了人口统计学、社交网络及到达ED时间的基线数据。以到达ED≤3小时作为结局，社交网络特征作为解释变量，性别作为潜在效应修饰因素进行逻辑回归分析。
独居或离婚的男性比与配偶同住（调整优势比[aOR]：0.31，95%置信区间[CI]：0.15 - 0.64）或已婚（aOR：0.45，95%CI：0.23 - 0.86）的男性在3小时内到达的可能性显著降低。在女性中，独居或离婚的女性与与配偶同住（aOR：1.25，95%CI：0.63 - 2.49）或已婚（aOR：0.73，95%CI：0.4 - 1.35）的女性在3小时内到达的几率相似。
在卒中/TIA患者中，只有男性与他人同住或已婚能缩短到达时间。改善卒中准备的行为干预应纳入社交网络影响到达时间方面的性别差异。
