Potisopha Wiphawadee, Vuckovic Karen M, DeVon Holli A, Park Chang G, Hershberger Patricia E
Wiphawadee Potisopha, MSN, RN PhD Student, College of Nursing, University of Illinois at Chicago. Karen M. Vuckovic, PhD, APRN, ACNS-BC, FAHA Assistant Professor, College of Nursing, University of Illinois at Chicago and Adjunct Faculty, College of Medicine, University of Illinois at Chicago. Holli A. DeVon, PhD, RN, FAHA, FAAN Professor and Associate Dean for Research, School of Nursing, University of California, Los Angeles. Chang G. Park, PhD Assistant Professor, College of Nursing, University of Illinois at Chicago. Patricia E. Hershberger, PhD, APRN, FNP-BC, FAAN Associate Professor, College of Nursing, University of Illinois at Chicago, and Affiliate Professor, College of Medicine, University of Illinois at Chicago.
J Cardiovasc Nurs. 2020 Nov/Dec;35(6):E77-E88. doi: 10.1097/JCN.0000000000000715.
In 2009, the window from symptom onset to administration of tissue plasminogen activator for acute ischemic stroke was extended from 3 to 4.5 hours. Yet no systematic review has addressed prehospital delay by sex for stroke symptoms since this change.
We aimed to (1) compare prehospital delay times-the time from symptom onset to hospital arrival-between women and men with acute stroke or transient ischemic attack and (2) summarize factors influencing prehospital delay by sex.
The CINAHL, MEDLINE, PubMed, Scopus, and PsycINFO databases were searched using PRISMA guidelines. Inclusion criteria were as follows: (1) quantitative research articles published between May 2008 and April 2019, (2) investigation of prehospital delay among women and men 15 years or older who were given a diagnosis of acute stroke or transient ischemic attack, and (3) English-language publications. The Crowe Critical Appraisal Tool was used to evaluate the quality of studies.
Fifteen publications (n = 162 856) met inclusion criteria. Most studies (n = 11) showed no sex differences in prehospital delay. Four studies from Asian-Pacific countries and the United States showed that women had significantly longer prehospital delay compared with men. Older age, minority race/ethnicity (black and Mexican American), and underuse of emergency medical services were associated with prolonged prehospital delay in women.
Most study authors found no differences in prehospital delay between women and men; however, women delayed longer in some Asian-Pacific and American studies. Findings of sex differences were inconclusive.
2009年，急性缺血性卒中从症状发作到给予组织纤溶酶原激活剂治疗的时间窗从3小时延长至4.5小时。然而，自这一变化以来，尚无系统评价探讨过卒中症状按性别划分的院前延误情况。
我们旨在（1）比较急性卒中和短暂性脑缺血发作的女性和男性患者的院前延误时间（从症状发作到入院的时间），以及（2）总结按性别划分影响院前延误的因素。
按照PRISMA指南检索CINAHL、MEDLINE、PubMed、Scopus和PsycINFO数据库。纳入标准如下：（1）2008年5月至2019年4月发表的定量研究文章，（2）对年龄在15岁及以上、被诊断为急性卒中和短暂性脑缺血发作的女性和男性患者的院前延误情况进行调查，以及（3）英文出版物。使用Crowe批判性评价工具评估研究质量。
15篇出版物（n = 162856）符合纳入标准。大多数研究（n = 11）表明院前延误无性别差异。来自亚太国家和美国的4项研究表明，与男性相比，女性的院前延误时间显著更长。年龄较大、少数族裔（黑人和墨西哥裔美国人）以及未充分使用紧急医疗服务与女性较长的院前延误相关。
大多数研究作者发现女性和男性在院前延误方面没有差异；然而，在一些亚太地区和美国的研究中，女性延误时间更长。性别差异的研究结果尚无定论。
