Diferencias en la supervivencia después de un episodio de ictus tratado con fibrinólisis. Estudio Ebrictus

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.