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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 623 525 Epidemiology of stroke Change in incidence of intracerebral haemorrhage in urban and rural northern Portugal, from 1999 to 2011: a population-based study M. Correai1, R. Magalhães2, R. Felgueiras3, M.R. Silva4, I. Matos5, C Quintas6, J.P. Gabriel7, E. Azevedo8, M.C. Silva9 on behalf of ACIN2 Investigators group Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, PORTO, PORTUGAL1, UNIFAI, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, PORTO, PORTUGAL2, Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, PORTO, PORTUGAL3, Serviço de Neurologia, Hospital de São Pedro - Centro Hospitalar de Trás-os-Montes e Alto Douro, VILA REAL, PORTUGAL4, Serviço de Neurologia, Hospital de Mirandela - Centro Hospitalar do Nordeste, MIRANDELA, PORTUGAL5, Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, PORTO, PORTUGAL6, Serviço de Neu-rologia, Hospital de São Pedro - Centro Hospitalar de Trás-os-Montes e Alto Douro, VILA REAL, PORTUGAL7, Serviço de Neurologia, Hospital de São João - Centro Hospitalar de São João, POR-TO, PORTUGAL8, UNIFAI, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, PORTO, PORTUGAL9 Background: One decade ago stroke incidence in Portugal was higher than in most Western Europe-an countries. The objective of this study is to know how much it has been achieved in the incidence and short term prognosis of primary intracerebral haemorrhages (PICH) from 1999 to 2011 in urban and rural areas. Methods: All suspect first-ever-in-a-lifetime stroke occurring between October 2009 and September 2011 in 46775 residents in rural areas and 193349 residing in the city of Porto were registered and are compared to those ascertained in the 1998-2000 study. Based on standard definitions, both hot and cold pursuit sources of information were used for case ascertainment. Patients were observed at onset and at three months. Results: During a 24-month period, 115 patients with a first-ever PICH, 27 in rural and 88 in urban areas were registered. The first PICH happens on average 4 years after (67 and 71 years) in the city and 6 years in rural areas (67 and 74 years). There was a decrease in the annual incidence rate of PICH per 100000, from 45 (95%CI, 37-53) to 24 (95%CI, 20-28), and from 33 to 16 after standard-ization to the European population. In the rural population the incidence dropped from 44/100000 (95%CI, 31-62) to 29 (95%CI, 19-42) and in the urban population from 45/100000 (95%CI, 36- 57) to 23 (95%CI, 18-28). Age-specific incidence decreased following similar patterns in rural and urban populations, reaching a relative reduction of 75.7% in urban populations aged 55-64 years. Case-fatality at 28 days decreased from 30.6% (95%CI, 22.8-39.7) to 28.7% (95%CI, 21.2-37.6 ) and from 33.3 to 22.7% in urban patients; in rural patients increased from 24.2 to 48.1%. Conclusion: The incidence and case-fatality of PICH decreased ten years apart, in particular in urban populations. The ageing of patients in rural areas could be responsible for their high case-fatality. Supported by FCT/FEDER project PIC/IC/82858/2007 526 Epidemiology of stroke MORTALITY AFTER THROMBECTOMY. IS IT A BAD SELECTION OR A TREAT-MENT FAILURE? P. Cardona1, H. Quesada2, L. Cano3, L. Aja4, P. Mora5, MA De Miquel6, R Barranco7, S. Aixut8, A. Escrig9, F. Rubio10 Bellvitge University Hospital. Department of Neurology, Hospitalet de Llobregat, SPAIN1, Bellvitge University Hospital. Department of Neurology, Hospitalet de Llobregat, SPAIN2, Depart-ment of Neurology. Hospital Universitari Bellvitge. IDIBELL. Barcelona, Hospitalet de Llobregat, SPAIN3, Department of Neuroradiology. Bellvitge University Hospital. IDIBELL. Barcelona, Hos-pitalet de Llobregat, SPAIN4, Department of Neuroradiology. Bellvitge University Hospital. Bar-celona, Hospitalet de Llobregat, 5, Department of Neuroradiology. Bellvitge University Hospital. Barcelona, Hospitalet de Llobregat, SPAIN6, Department of Neuroradiology. Bellvitge University Hospital. Barcelona, Hospitalet de Llobregat, SPAIN7, Department of Neuroradiology. Bellvitge University Hospital. Barcelona, Hospitalet de Llobregat, SPAIN8, Parc Sanitari Sant Joan de Deu. Department of Neuroradiology, Sant Boi, SPAIN9,Department of Neurology. Hospital Universitari Bellvitge. IDIBELL. Barcelona, Hospitalet de Llobregat, SPAIN10 Background: Treatment of cerebral vascular occlusion by using devices to restore circulation im-proves the success of recanalization and clinical outcome. In our experience neurointerventional treatment have good results when they are caused by large vessel occlusions (good outcome >50% of patients). However mortality represents a fifth part of patients treated. Methods: We studied 213 consecutive patients treated with neurointerventional treatments (stent-re-trieval) with vascular occlusion in our comprehensive stroke center, from January 2010 to No-vember 2012. We analyze patients who died compared with the group of patients alive. We review mortality associated to age, stroke location, basal NIH score, ASPECT score, basal mRS, successful recanalization (TICI 2b-3), symptomatic cerebral hemorrhage (SICH) and other epidemiological variables. Results: Thirty-six patients died (18% mRS 6 at 3 months). Their basal mRS 0-1 was 78% and me-dian NIHSS 20. Mean age in this group was significant higher than alive patients (76 vs 65 years). If we compare patients dead with alive, vertebrovasilar/TICA occlusions and ASPECTS<9 were variables associated to high mortality (52% vs 24%, and 41% vs 17%; p< 0.001). Successful re-canalitzation rate was achieved in 47% of dead patients (TICI 2b-3) vs 80% in patients alive. Princi-pal causes of death were SICH 33%, massive infarcts24%, lung infections 25% and other systemic complications. Twenty-five percent of patients had a delayed death between 1-3 months after treat-ment. Conclusions: It is feasible and reasonably safe to continue using neurointerventional treatment in severe strokes associated to extensive strokes. But several selection criteria as vertebrobasilar/TICA strokes, elderly patients and ASPECTS<9 have a higher mortality. However the poor results of con-servative treatment in this group of patients may justify the compassionate use of thrombectomy. New devices could improve the percentage of successful recanalization.


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