Supplementary Material for: Sex-Based Analysis of Treatment, Time Metrics and Outcomes in Acute Ischemic Stroke Patients Treated in the Netherlands.

Introduction
Sex disparities in stroke treatment have gained increasing interest, especially since women have worse post-stroke functional outcomes compared with men. Existing studies provide conflicting evidence, with some indicating women have longer delays and less often receive acute treatment, whereas others show no differences between men and women. We aimed to explore sex differences in acute treatment modalities and time metrics of patients with acute ischemic stroke (AIS) in a real-world setting. Secondly, we examined whether functional outcomes differed by sex and whether this was influenced by treatment timing.

Methods
We analyzed data from the Dutch Acute Stroke Audit, a prospective consecutive registry of AIS patients from 72 hospitals in the Netherlands, between 2017 and 2020. We captured data on type of treatment administered (intravenous thrombolysis [IVT] and endovascular thrombectomy [EVT]), time metrics (onset-to-door time [OTDT], door-to-needle and door-to-groin times), and functional outcomes at three months (modified Rankin scale [mRS]). The association between sex and poor outcome (mRS 3-6) was assessed with Cox proportional hazard models stratified by type of treatment and adjusted for age, additionally for National Institute of Health Stroke Scale (NIHSS) and OTDT.

Results
Of the 58,632 patients, 26,941 (46%) were women. Compared with men, women were, older (mean age 74.6 versus 71.0, p

引言
在卒中治疗领域，性别差异问题日益受到关注，尤其是鉴于女性相较于男性在卒中后的功能恢复方面存在更差的预后。现有研究提供了相互矛盾的证据，其中一些研究表明女性在治疗延迟和接受急性治疗方面的频率较低，而另一些研究则显示男性和女性之间没有差异。本研究旨在探讨在真实世界环境中，急性缺血性卒中（AIS）患者在急性治疗方式及时间指标方面的性别差异。其次，我们考察了功能预后是否因性别而异，以及这种差异是否受到治疗时机的影响。

方法
我们分析了荷兰急性卒中审计的数据，该审计是一项前瞻性连续登记，记录了2017年至2020年间荷兰72家医院的AIS患者数据。我们收集了治疗类型（静脉溶栓[IVT]和血管内溶栓[EVT]）、时间指标（发作至门时间[OTDT]、门至针和门至髂股时间）以及三个月时的功能预后（改良Rankin量表[mRS]）的数据。通过Cox比例风险模型评估了性别与不良预后（mRS 3-6）之间的关联，模型按治疗类型分层，并调整了年龄，此外还调整了美国国立卫生研究院卒中量表（NIHSS）和OTDT。

结果
在58,632名患者中，26,941名（46%）为女性。与男性相比，女性年龄更大（平均年龄74.6岁 versus 71.0岁，p