ABSTRACT NUMBER: ESOC2026A2234 SEX DIFFERENCES IN CEREBROVASCULAR HOSPITAL MORTALITY IN A PRIMARY STROKE CENTER

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Abstract Background and aims Analyse sex differences in hospital mortality in a primary stroke center Methods Clinical and demographic variables of patients who died in our center since opening of Stroke Unit in October 2021 to December 2025 are described. Results Number of deaths was higher in women (101 vs 53 patients) Average age is higher in women (84.7 vs 79.1 years-old) and more institutionalized (29.7 vs 17%). Men live mainly with her couple (47.2 vs 25.7%). Women have higher Rankin Scale (≥3, 71 vs 33.9%). Code stroke activation is higher in men (45.3% vs 31.7%). Onset to “door time” is higher in women (129 vs 86.5 minutes), although time activation in Emergency is almost the same. Most frequent onset symptom in both sexes is hemiparesis/hemihypoesthesia. NIHSS at admission, neurological and systemic complications are similar. Main immediate cause of death is intracranial hypertension in both sexes. Ischemic stroke is more frequent in women (64.4%), hemorrhagic in men (50.9%). In ischemic stroke, TACI is more frequent in women (69.2 vs 55.6%) and POCI in men (22.2 vs 3.1%). In TOAST classification, cardioembolic is more frequent in women (67.7 vs 55.6%). Conclusions Cerebrovascular deaths in our hospital are almost double in women. Sex and gender are a known risk factor in strokes, generating a disproportionate burden of mortality in women, which is difficult to explain solely as a biological phenomenon. Less recognized aspects, such as women's own response to the disease and others related to the care provided in healthcare services, also underlie the basis of the problem. Conflict of interest All of authors have nothing to disclose

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