We aimed to evaluate the effect of some simple modifications on reducing sex disparities, with a focus on Door-to-needle (DTN) time.

DTN is an important factor in managing stroke for which studies have reported delays in women.

This longitudinal cohort study was conducted between September 2019, and August 2021, at a comprehensive stroke center. Previously we utilized the conventional “D’s of stoke care” for timely management. Some simple modifications were implemented in September 2020, with a special focus on the time of the neurologist's evaluation (D4-B) and patients’ transfer to the stroke unit (D6-B). Patients were analyzed in two groups: group 1, before, and group 2, after employing the modifications. Sex as the main variable of interest along with other selected covariates were regressed towards the DTN, using univariable and multivariable logistic regressions.

We enrolled 47 and 56 patients who received intravenous thrombolysis in groups 1 and 2, respectively. Although there was a significant difference in DTN≤ 1 hour between women and men in group 1 (36% vs. 52%, p= 0.019), it was not significantly different in group 2 (48% vs. 48.4%, p= 0.97). Furthermore, regression analysis showed being female was a significant predictor of DTN> 1 hour in group 1 (aOR= 6.65, p= 0.02), while after employing the modifications gender was not a predictor of delayed DTN.

Although we have a long way to achieve performance measures in developed countries, we seem to have succeeded in reducing gender disparities in DTN using these simple modifications.