de Campos Lívia Mizuki, Martins Bruna Mariah, Cabral Norberto Luiz, Franco Selma Cristina, Pontes-Neto Octávio Marques, Mazin Suleimy Cristina, Dos Reis Felipe Ibiapina
Department of Medicine, University of Joinville Region, Joinville, Santa Catarina, Brazil.
Joinville Stroke Registry, University of Joinville Region, Joinville, Santa Catarina, Brazil.
PLoS One. 2017 Jan 20;12(1):e0170204. doi: 10.1371/journal.pone.0170204. eCollection 2017.
The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32.7%. Of 303 patients with first-ever ischaemic stroke (IS), one-third were FD at discharge, and 12%, 9% and 8%, respectively at 1, 2 and 3 years. Among 37 patients with haemorrhagic stroke (HS), 38% were dependent at discharge, 16% after 1 and 2 years and 14% after 3. Among 27 patients with subarachnoid haemorrhage (SAH), 19% were dependent at discharge and 4% from 1 to 3 years. Among IS subtypes, cardioembolic ones had the worst risk of FD. (RR 19.8; 95% CI: 2.2 to 175.9). Our results showed that one-third of stroke survivors have FD during the first year after stroke in Brazil. Therefore, a city with half a million people might expect 120 new stroke patients with FD each year.
中风死亡率的下降将增加功能依赖（FD）幸存者的负担。本研究的目的是评估在巴西茹安维尔，有多少患者在发生中风事件3年后出现功能依赖。通过经过验证的电话访谈评估了茹安维尔中风登记处中风幸存者中FD（定义为改良Rankin量表评分为3至5分）的比例。茹安维尔中风后一年的FD发病率为每10万人口23.24例。出院时中风幸存者中FD的总体比例为32.7%。在303例首次发生缺血性中风（IS）的患者中，三分之一在出院时存在功能依赖，在1年、2年和3年时分别为12%、9%和8%。在37例出血性中风（HS）患者中，38%在出院时存在功能依赖，1年和2年后为16%，3年后为14%。在27例蛛网膜下腔出血（SAH）患者中，19%在出院时存在功能依赖，1至3年为4%。在IS亚型中，心源性栓塞性中风发生功能依赖的风险最高（风险比19.8；95%置信区间：2.2至175.9）。我们的结果显示，在巴西，三分之一的中风幸存者在中风后的第一年存在功能依赖。因此，一个拥有50万人口的城市每年可能会新增120例有功能依赖的中风患者。
