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Hospitalization for ischemic stroke in Brazil: an ecological study on the possible impact of Hiperdia
Johnnatas Mikael Lopes1, Gerônimo José Bouzas Sanchis2, Jovany Luiz Alves de Medeiros3
1Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Objective:
The study evaluated the trend of hospitalization for ischemic stroke (HIS) and its hospital mortality in Brazil over the last 15 years as well as the impact of the Hiperdia program in this scenario.
Methods:
An ecological study was designed with analytical approach and data collected in the Hospital Admission System on episodes of stroke, over the years 1998 to 2012. All data were stratified by sex and age, creating an indicator for HIS and proportion of hospital mortality. To estimate the trend of the data a polynomial curve fitting was created; and the Generalized Linear Model was applied to investigate the impact of Hiperdia on the endpoint HIS and hospital mortality. We adopted a 5% significance level to minimize an error type I.
Results:
We observed a reduction of HIS from 37.57/105 inhabitants in 1998 to 2001 to 10.33/105 inhabitants in 2002 to 2005, declining 73.64%. The reduction occurred in both sexes and for all age groups. The mortality rate of ischemic stroke also declined in Brazil since 2002, in both men and women, therefore in less than 3%; and only in the groups aged between 0 and 14 and above 80 years, we did not detect trend.
Conclusion:
Therefore, the decline of HIS temporally coincided with the implementation of Hiperdia in 2002 and this trend continues today.
