[Differences in the survival after an episode of stroke treated with thrombolytic therapy. Study Ebrictus]

Jose Luis Clua-Espuny, Rosa Ripolles-Vicente, Carlos Lopez-Pablo, Anna Panisello-Tafalla, Jorgina Lucas-Noll, Cristina Calduch-Noll, M Antonia González-Henares, M Lluisa Queralt-Tomas, Jose Luis Clua-Espuny, Rosa Ripolles-Vicente, Carlos Lopez-Pablo, Anna Panisello-Tafalla, Jorgina Lucas-Noll, Cristina Calduch-Noll, M Antonia González-Henares, M Lluisa Queralt-Tomas

Abstract

Objective: To seek if there is gender survival difference among patients treated with thrombolytic therapy.

Design: Cohort study.

Location: Community based register.

Participants: 91 subjects with an episode of stroke collected since April 2006 up to September 2013 and treated with thrombolytic therapy.

Interventions: Monitoring of vital status.

Measurements: We collected baseline characteristics in Framingham, Regicor, CHA2DS2-VASc, Essen, NIHSS, Barthel scales and outcomes according to gender; person-time incidence rate; survival analysis by Kaplan-Meier's curves, bivariate analysis between survivors and deaths, and Cox multivariate.

Results: 91 patients with middle age 68.02±11.9 years. The men have higher cardiovascular basal risk. The average time of follow-up was 2.95±2.33 years. Incidence rate ratio (IR) shown higher risk in men than in women IR=3.2 (CI 95% 1.2-8.0). The dead cases were older (P=.032); with higher cardiovascular basal risk (P=.040) and more risk of stroke recurrence (P=<.001), with cardiovascular pathology before the stroke (P=.005); more stroke severity (P=.002); and a major fall in the score Barthel one year after the episode (P=.016). The percentage of deaths is significantly higher when the patient is referred by complications to other centres (P=.006) in relation to those referred to home, but just the gender (HR: 1,12; IC 95%: 1,05-1,20) and secondary cardiovascular prevention (HR: 0,13; IC 95%: 0,06-0,28) were associated with higher risk of mortality.

Conclusions: After stroke episode treated with thrombolytic therapy, men have 12% higher risk of dying than women and don't be treated with secondary cardiovascular prevention rise 7.7 times the mortality risk.

Keywords: Atención primaria; Fibrinólisis; Gender; Género; Ictus; Primary care; Stroke; Supervivencia; Survival; Thrombolysis.

Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Figures

Figura 1
Figura 1
Curva de supervivencia acumulada al final del estudio. Ebrictus, 2013.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6983802/bin/fx1.jpg
Esquema del estudio: Estudio de cohortes para investigar la relación entre género y supervivencia después de un episodio de ictus tratado con fibrinólisis. Ebrictus 2013.

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Source: PubMed

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