Sex and Race-Ethnic Disparities in Door-to-CT Time in Acute Ischemic Stroke in the FL-PR CReSD

Objective: To identify temporal trends and sex & race-ethnic differences in door-to-CT time (DTC) after acute stroke. Background: Less than forty percent of patients with suspected stroke have CT imaging performed within 25 min of hospital arrival. We aimed to examine race-ethnic and sex differences in DTC ≤ 25 min and temporal trends in receiving DTC ≤ 25 in the Florida-Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD). Design/Methods: Data was collected from 31,905 suspected stroke patients from the FL-PR Stroke Registry and secondary analysis was performed on 6,636 IV tPA-treated cases. Generalized estimating equation models were used to determine predictors of DTC ≤ 25. Results: DTC ≤ 25 was achieved in 46% of cases of suspected acute stroke. Examination of temporal trends revealed that receiving DTC ≤ 25 improved from 37% in 2010 to 57% in 2015. Women were less likely to receive DTC ≤ 25 compared to men. FL Blacks and PR Hispanics had the lowest percentage of achieving DTC ≤ 25. Arrival by EMS and NIHSS > 5 were predictors of receiving DTC ≤ 25, while previous history of CAD/MI or stroke/TIA were associated with DTC > 25. After adjustment, women and FL Blacks were less likely to receive DTC ≤ 25 (OR 0.9, 95% CI 0.87–0.94 and OR 0.85, 95% CI 0.78–0.93, respectively). Additionally, in a secondary analysis in patients treated with IV tPA, % DTC ≤ 25 was significantly higher, DTC ≤ 25 similarly improved over time, and women were still less likely to receive DTC ≤ 25 (OR 0.87, 95% CI 0.77–0.99), while no significant differences were observed by race-ethnicity. Conclusions: In the FL-PR CReSD, there are considerable improvements in receiving DTC ≤ 25 from 2010 to 2015. However, women and Blacks are less likely to receive DTC ≤ 25 than Whites during acute stroke hospitalization. Disclosure: Dr. Perez has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Ciliberti-Vargas has nothing to disclose. Dr. Gutierrez has nothing to disclose. Dr. Oluwole has nothing to disclose. Dr. Dong has nothing to disclose. Dr. Sacco has nothing to disclose. Dr. Rundek has nothing to disclose.