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Stroke incidence, prognosis, 30-day, and 1-year case fatality rates in Matão, Brazil: a population-based prospective
Cesar Minelli1, Lee Fu Fen, Denise P Camara Minelli
1Department of Neurology , Hospital Carlos Fernando Malzoni, Rua Sinharinha Frota, 556-Centro, Matão, São Paulo, Brazil. cminelli@netsite.com.br
Insights
This study reports the first prospective population-based incidence of stroke in Brazil, revealing high stroke burden and case fatality rates. Findings highlight the need for interventions to reduce stroke impact in Brazil.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke is a leading cause of death in Brazil.
- No prior prospective population-based studies on stroke incidence existed in Brazil.
Purpose of the Study:
- To determine the incidence of stroke and its subtypes in Matão, Brazil.
- To assess stroke case fatality and 1-year prognosis.
- To establish a baseline for future stroke prevention studies in Brazil.
Main Methods:
- Prospective, population-based study in Matão, Brazil (population 75,053).
- Case ascertainment using overlapping methods from November 2003 to October 2004.
- Follow-up at 1 month and 1 year post-stroke, adhering to standard criteria.
Main Results:
- Identified 81 first-ever-in-a-lifetime strokes.
- Crude annual incidence rate: 108/100,000; age-adjusted rate: 137/100,000.
- Ischemic stroke: 85.2%, intracerebral hemorrhage: 13.6%.
- 30-day case fatality: 18.5%; 1-year case fatality: 30.9%.
- After 1 year: 43% independent in daily activities, 49.4% independent gait, 15.9% recurrent stroke.
Conclusions:
- Stroke incidence and fatality rates in Matão are comparable to other population-based studies globally.
- Results underscore the significant stroke burden in Brazil.
- Further research in Matão is crucial for developing strategies to mitigate stroke impact.
Background And Purpose:
Stroke is the main cause of death in Brazil and no prospective population-based study has been conducted in the country. The purpose of this study was to determine the incidence of stroke, stroke subtypes, case fatality, and prognosis after 1 year of follow-up in the city of Matão, Brazil.
Methods:
Using overlapping methods of case ascertainment, all stroke cases that occurred in the city of Matão (population, 75,053) from November 1, 2003 to October 31, 2004 were followed-up at 1 month and 1 year after the episode. Standard criteria for population-based stroke studies were followed.
Results:
Of 141 suspect stroke cases identified, 81 were first-ever-in-a-lifetime strokes. All patients underwent a CT scan. The crude annual incidence rate per 100,000 per year was 108 (95% CI, 85.7-134.1) and the rate adjusted for sex and age to the Segi population was 137 (95% CI, 112.0 to 166.4) per 100,000 inhabitants per year. Ischemic stroke occurred in 69 (85.2%) subjects, intracerebral hemorrhage in 11 (13.6%), and subarachnoid hemorrhage in 1 (1.2%). The 30-day case fatality rate was 18.5 and the 1-year case fatality rate was 30.9%. After 1 year of follow-up, 43% of the patients were independent in activities of daily living, 49.4% had independent gait, and 15.9% had a recurrent stroke.
Conclusions:
The present results are similar to those obtained in other stroke population-based studies. Future studies in Matão will provide the opportunity to discover ways to decrease the stroke burden in Brazil.
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