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Title: Stroke Epidemiology, Patterns of Management, and Outcomes in Fortaleza, Brazil A Hospital-Based Multicenter Prospective Study
Authors: Freitas de Carvalho, Joao Jose
Alves, Monique Bueno
Andrade Viana, Georgiana Alvares
Machado, Cicera Borges
Cardoso dos Santos, Bento Fortunato
Kanamura, Alberto Hideki
Lottenberg, Cláudio Luiz [UNIFESP]
Cendoroglo Neto, Miguel [UNIFESP]
Silva, Gisele Sampaio [UNIFESP]
Hosp Geral Fortaleza
Hosp Israelita Albert Einstein
Dept Hlth
Universidade Federal de São Paulo (UNIFESP)
Keywords: Brazil
South America
stroke care
Issue Date: 1-Dec-2011
Publisher: Lippincott Williams & Wilkins
Citation: Stroke. Philadelphia: Lippincott Williams & Wilkins, v. 42, n. 12, p. 3341-U48, 2011.
Abstract: Background and Purpose-Little information exists on the epidemiology and patterns of treatment of patients admitted to Brazilian hospitals with stroke. Our objective was to describe the frequency of risk factors, patterns of management, and outcome of patients admitted with stroke in Fortaleza, the fifth largest city in Brazil.Methods-Data were prospectively collected from consecutive patients admitted to 19 hospitals in Fortaleza with a diagnosis of stroke or transient ischemic attack from June 2009 to October 2010.Results-We evaluated 2407 consecutive patients (mean age, 67.7 +/- 14.4 years; 51.8% females). Ischemic stroke was the most frequent subtype (72.9%) followed by intraparenchymal hemorrhage (15.2%), subarachnoid hemorrhage (6.0%), transient ischemic attack (3%), and undetermined stroke (2.9%). the median time from symptoms onset to hospital admission was 12.9 (3.8-32.5) hours. Hypertension was the most common risk factor. Only 1.1% of the patients with ischemic stroke received thrombolysis. the median time from hospital admission to neuroimaging was 3.4 (1.2-26.5) hours. In-hospital mortality was 20.9% and the frequency of modified Rankin Scale score <= 2 at discharge was less than 30%. Older age, prestroke disability, and having a depressed level of consciousness at admission were independent predictors of poor outcome; conversely, male gender was a predictor of good outcome.Conclusions-The prevalence of stroke risk factors and clinical presentation in our cohort were similar to previous series. Treatment with thrombolysis and functional independency after a stroke admission were infrequent. We also found long delays in hospital admission and in evaluation with neuroimaging and high in-hospital mortality. (Stroke. 2011;42:3341-3346.)
ISSN: 0039-2499
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