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[Epidemiology of cerebrovascular disease in Joinville, Brazil. An institutional study]
N L Cabral1, A L Longo, C H Moro
1Neurologistas da Clínica Neurológica de Joinville, SC, Brasil.
Insights
This study found a high incidence of first-time stroke in Joinville, Brazil, with cerebral infarcts being the most common type. Mortality and fatality rates were comparable to other global populations.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Context:
- Limited epidemiologic data on cerebrovascular disease in Brazil.
- Previous impressions suggested a high incidence of stroke in the region.
Purpose:
- To prospectively determine the incidence, mortality, and risk factors of first and recurrent stroke episodes in Joinville, Brazil.
- To analyze pathological subtypes, hospitalization times, and early outcomes of stroke patients.
Summary:
- The study registered 429 stroke patients from March 1995 to March 1996, with 320 experiencing their first episode.
- Annual incidence of first stroke was 156/100,000, with cerebral infarcts (73.4%) predominating over cerebral hemorrhage (18.4%) and subarachnoid hemorrhage (7.5%).
- 30-day fatality rate was 26%, with hypertension, prior stroke, and diabetes as key risk factors. Only 25% received care within three hours of symptom onset.
Impact:
- Provides crucial epidemiologic data on stroke incidence and characteristics in Brazil.
- Highlights the need for improved and timely stroke care access.
- Findings are comparable to international stroke data, aiding global health comparisons.
Abstract:
The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case ráte (in 30 days lethality), frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients were submited to at least one computed tomography scanning. The episodes of cerebral infarcts were divided in pathological sub-types. Results showed that the annual incidence adjusted to the age of first stroke episode was 156/100,000. The distribution by diagnosis was: 73.4% for cerebral infarct, 18.4% for cerebral hemorrhage and 7.5% for subarachnoid hemorrhage. The annual standard mortality rate was 25/100,000. The fatality case global rate in 30 days was 26%. Hypertension, previous stroke and diabetes were the most frequent risk factors. Only 25% of the patients were assisted within three hours of the onset of stroke. We concluded that the incidence rate of first episode of stroke is high in institutionalized patient in Joinville, Brazil. The mortality and fatality--case rates are similar to the ones of other populations.