{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:24:31Z","timestamp":1787757871687,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Population-based sex differences in large vessel occlusion (LVO) screening and thrombectomy use for acute ischemic stroke are not well understood. We compared the detection of LVO, thrombectomy use, and long-term clinical outcomes in female versus male patients with cerebral ischemia in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This retrospective cohort study used data from the Ontario Stroke Registry linked with health administrative data. We included adult patients hospitalized for cerebral ischemia within the first 24 hours of last seen normal time during 2 fiscal years (2019\/2020 and 2022\/2023). We used modified Poisson regression models to evaluate sex differences in intracranial neurovascular imaging, thrombolysis, or thrombectomy. Among patients with LVO, we used Cox proportional hazard and cause-specific hazard models to compare female versus male patients long-term mortality, readmission, or nursing home admission until 2025, stratified by thrombectomy treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 16\u2009935 eligible patients (47% female patients; median age, 76 [interquartile range, 65\u201384] years), female patients were less likely than male patients to receive intracranial neurovascular imaging (83.6% female versus 87.8% male;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). Among those who underwent imaging, 19.3% of female patients had an LVO compared with 15.9% of male patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). Thrombectomy use was higher in female patients than male patients in the overall cohort (adjusted relative risk, 1.08 [1.01\u20131.16]), but, once restricted to those with LVO, thrombectomy use was similar (adjusted relative risk, 0.98 [0.93\u20131.03]). Adjusted hazard of the composite outcome was lower in female patients with LVO treated with thrombectomy compared with their male counterparts (adjusted hazard ratio, 0.88 [0.77\u20130.99]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Female patients with acute cerebral ischemia were less likely than male patients to receive intracranial neurovascular imaging but more likely to have an LVO, and long-term mortality was lower in female patients with LVO treated with thrombectomy. Stroke outcomes\u2019 research must account for neurovascular imaging and LVO status to accurately identify sex-based disparities in stroke care and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.126.055991","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:00:16Z","timestamp":1783674016000},"page":"2780-2788","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Screening for Large Vessel Occlusion and Thrombectomy: A Population-Based Cohort Study"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-4377","authenticated-orcid":true,"given":"Yasodara P.S.","family":"Siddharthan","sequence":"first","affiliation":[{"name":"Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, ON, Canada (Y.P.S.S., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3444-9928","authenticated-orcid":true,"given":"Moira K.","family":"Kapral","sequence":"additional","affiliation":[{"name":"Department of Medicine (General Internal Medicine) (M.K.K.), University of Toronto, University Health Network, ON, Canada."},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada (M.K.K., J.F., P.C.A., A.C., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-0987","authenticated-orcid":true,"given":"Jiming","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada (M.K.K., J.F., P.C.A., A.C., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3337-233X","authenticated-orcid":true,"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada (M.K.K., J.F., P.C.A., A.C., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6619-3388","authenticated-orcid":true,"given":"Anahita","family":"Carbonneau","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada (M.K.K., J.F., P.C.A., A.C., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6269-1543","authenticated-orcid":true,"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, AB, Canada (M.D.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8445-1447","authenticated-orcid":true,"given":"Albert","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), Queen\u2019s University, Kingston Health Sciences Centre, ON, Canada (A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-0695","authenticated-orcid":true,"given":"Jennifer","family":"Mandzia","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Western University, London Health Sciences Centre University Hospital, ON, Canada (J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-8429","authenticated-orcid":true,"given":"Frank L.","family":"Silver","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology) (F.L.S.), University of Toronto, University Health Network, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-9551","authenticated-orcid":true,"given":"Amy Y.X.","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, ON, Canada (Y.P.S.S., A.Y.X.Y.)."},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada (M.K.K., J.F., P.C.A., A.C., A.Y.X.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemini","family":"Abraham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess","family":"Fitzpatrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Gerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Heffernan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira K.","family":"Kapral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. Anna","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Maebrae-Waller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Mandzia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilavarasy","family":"Maran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukul","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Stotts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Y.X.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70193-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.048303"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.045320"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000513"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032850"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201372"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.026723"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028589"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024651"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.025344"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000411"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2025.13"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa031697"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2016.278"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2022.344"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.114.001416"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2020.9"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1159\/000314715"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.11.010"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017719"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2022.1032592"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029949"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000424"},{"key":"e_1_3_3_26_2","unstructured":"Heart and Stroke Foundation of Canada. Acute Stroke Management Definitions 2022 update. 2022. Accessed May 14 2025. https:\/\/www.strokebestpractices.ca\/recommendations\/acute-stroke-management\/definitions"},{"key":"e_1_3_3_27_2","unstructured":"Accreditation Canada. Stroke Distinction. 2025. Accessed May 14 2025. https:\/\/accreditation.ca\/stroke-distinction\/"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70092"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221091648"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023867"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-018348"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7075"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214403"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01820-8"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.126.055991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:56:40Z","timestamp":1787756200000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.126.055991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":33,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1161\/STROKEAHA.126.055991"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.126.055991","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}