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Authors & Affiliations: Josep L Clua-Espuny (1), Teresa Forcadell-Arenas (1), Rosa Ripolles-Vicente (1), Panisello-Tafalla(1), Antonia González-Henares (1), Lluïsa Queralt-Tomas (1), Carles Anna López-Pablo (2), Iñigo Lechuga-Duran (3) ,
Jorgina Lucas-Noll (1), Miquel Gallofré López (4) on Behalf of Ebrictus Group Investigators1.
(1) Primary care. Institut Català de la Salut. Terres de l’Ebre. Tortosa. España. (2) USR Terres de l’Ebre. IDIAP Jordi Gol-IISPV. Tortosa. (3) Cardiology. Institut Catala de la Salut. Terres de l’Ebre. Tortosa.
España. (4) Pla Director de la Malaltia Vascular Cerebral de Catalunya. Dpt de Salut Cataluña, Barcelona.
Results of treatment with fibrinolysis in ischemic stroke. Survival differences by sex. Ebrictus
Project.
.
SURVIVAL-ALL
follow (years)
1086420-2
surv
ival
pro
babi
lity
1,2
1,0
,8
,6
,4
,2
0,0
-,2
gendre
MEN
WOMEN
SURVIVAL THROMBOLYSIS VS NOT
FOLLOW (years)
1086420-2
SUR
VIV
AL
PR
OB
ABIL
ITY
1,2
1,0
,8
,6
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0,0
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thrombolysis
not
yes
thrombolysis survival vs gender
follow up (days)
3000200010000-1000
surv
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1,2
1,0
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gender
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w omen
ALT PIRINEU-ARANGI RONA
LLEIDACENTRAL
BARCELONA
TARRAGONA
TERRES DE L'EBRE
Garrigues
Alt Empordà
BaixEmpordà
Maresme
VallèsOriental
VallèsOccidental
BarcelonèsBaixLlobregat
Cerdanya
Solsonès
Bages
Berguedà
Ripollès
Osona
Selva
Pla del’Estany
Garrotxa
Garraf
SegriàConca
de Barberà
Segarra
Noguera
Priorat
PallarsSobirà
PallarsJ ussà
Gironès
Alt Penedès
Anoia
TarragonèsBaixCamp
Urgell
Alt Urgell
AltCamp
Baix Ebre
AltaRibagorça
BaixPenedès
Montsià
Riberad’Ebre
TerraAlta
Plad’Urgell
Val d’Aran
LlegendaCentres amb Codi Ictus Implementats
prèviament al Pla Director.
Centres amb Codi Ictus Implementats i impulsats pel Pla Director.
2006
Centres de referència Codi Ictus, Catalunya 2006
“Pla Director de les Malalties de l’Aparell Circulatori”
Rationale A number of large trials have confirmed the benefits of thrombolysis in acute stroke, but there are gender differences in stroke.Methods & ResultsEbrictus Project is a study based on a cohort population from incident cases on the first stroke episode (included TIA) from 01/04/2006 to 31/12/2014 participated by Primary care and neurological service referent. Statistical approaches for analyzing survival outcomes and their relation with thrombolysis therapy.A total of 1337 first-ever strokes were included (614 in women). Mean age 74.06±11.9 years (25-90), higher percentage (p 0.004) women than men (54.1%), and significant differences (p <0.001) in the mean age men (72.34±11.9) and females (76.09±11.7) and significantly older (p <0.001) than those in the thrombolysis (68.8±12.0).
The mean follow-up was 3.12±2.51 years. The average disease duration is 6.67 years. At 90 days was similar in men and women 8% of deaths and at five years an 44.9%(ICI95% 42.2-47.6). No differences in adjusted mortality rates between sexes (Fig. 1). The incidence rate ratio by sex is 1.003 (IC95%0.86-1.17). Cumulative probability of overall survival is 0.92±0.08 the first month, 0.77±0.01 in the first year and 0.52±0.01 at five
The mortality curves among the ischemic with or without thrombolysis are significantly (p <0.003) different (Fig. 2). The Incidence Ratio is 0.57 (CI95% 0.39-0.83). The reduction RRR is 39.8% and ARR 18%, and the NNT 5 to prevent one death. Were identified as protective factors of mortality: the realization of thrombolysis (CI95% 0.37-0.80 p 0.002), and Barthel ≥ 60 (CI95% 0.81- 0.94 p 0.002) score.
Conclusion The thrombolysis reduces the mortality and disability after first stroke episode, especially among women, and the secondary cardiovascular prevention reduces 7 times the risk of
mortality. These results suggest a significant major probability of survival among women that increases progressively beyond 3 months.
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