Hospital Geral de Fortaleza, Fortaleza, Brazil.
Stroke. 2011 Dec;42(12):3341-6. doi: 10.1161/STROKEAHA.111.626523. Epub 2011 Nov 3.
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.
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.
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.
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.
有关因中风而住院的巴西患者的流行病学和治疗模式的信息很少。我们的目的是描述巴西福塔雷萨市因中风住院患者的危险因素频率、治疗模式和结局。
从 2009 年 6 月至 2010 年 10 月，连续前瞻性地收集了 19 家福塔雷萨医院诊断为中风或短暂性脑缺血发作的患者的数据。
我们评估了 2407 例连续患者（平均年龄 67.7±14.4 岁，51.8%为女性）。缺血性中风是最常见的亚型（72.9%），其次是脑实质内出血（15.2%）、蛛网膜下腔出血（6.0%）、短暂性脑缺血发作（3%）和未确定的中风（2.9%）。从症状发作到入院的中位数时间为 12.9（3.8-32.5）小时。高血压是最常见的危险因素。仅有 1.1%的缺血性中风患者接受了溶栓治疗。从入院到神经影像学检查的中位数时间为 3.4（1.2-26.5）小时。住院死亡率为 20.9%，出院时改良 Rankin 量表评分≤2 的频率低于 30%。年龄较大、发病前残疾以及入院时意识水平降低是预后不良的独立预测因素；相反，男性是预后良好的预测因素。
我们队列中的中风危险因素和临床表现与以前的系列研究相似。溶栓治疗和中风入院后功能独立性的治疗都很少见。我们还发现入院和神经影像学评估的时间延迟较长，住院死亡率较高。
