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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

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lity

1,2

1,0

,8

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,2

0,0

-,2

gendre

MEN

WOMEN

SURVIVAL THROMBOLYSIS VS NOT

FOLLOW (years)

1086420-2

SUR

VIV

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PR

OB

ABIL

ITY

1,2

1,0

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thrombolysis

not

yes

thrombolysis survival vs gender

follow up (days)

3000200010000-1000

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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.