Bando Daniel Hideki, Chiaravalloti Neto Francisco, Queiroz Alfredo Pereira de
Universidade Federal de Alfenas, Instituto de Ciências da Natureza, Alfenas, MG, Brazil.
Universidade de São Paulo, Faculdade de Saúde Pública, São Paulo, SP, Brazil.
Epidemiol Serv Saude. 2024 Dec 9;33:e20240017. doi: 10.1590/S2237-96222024v33e20240017.en. eCollection 2024.
To analyze spatio-temporal evolution of stroke mortality in Minas Gerais state, Brazil, 1980-2021.
Ecological study with aggregated data by micro-region. Segmented linear regression was used for trend analysis; maps with rates per five-year period and scan statistics were used for spatial analysis.
There were 392,521 stroke-related deaths (rate of 52.6/100,000-year). All rates (crude, adjusted, by age group) showed a decreasing trend, less so in the crude rate (Annual Percent Change [APC] = -0.70) and a faster decrease in the 20-39 age group (APC = -4.48). A high-rate cluster was identified in the southern region (1980-1999; Relative Risk [RR] = 2.06), and a low-rate cluster in the northwest (2008-2021; RR = 0.59). The most significant decrease occurred in the south (APC = -3.64).
Stroke mortality showed a decreasing trend. Clusters and areas with higher rates identified in the northeast in recent years require attention by service managers.
Decreasing trend in stroke mortality, a cluster was found in the south with high rates (1980-1999; relative risk [RR] = 2.06) and another in the northwest with low rates (2008-2021; RR = 0.59).
For health service managers, greater attention is suggested in the micro-regions and respective municipalities in the northeast that have presented a higher risk of mortality from stroke in recent years, with the aim of improving the regulation of health care service and network regulation, as well as optimizing access to these services.
It is necessary to monitor the spatio-temporal evolution of stroke mortality and conduct new studies on different scales (for example, on the municipal scale) and methodologies (for example, multilevel analysis), to estimate risk factors and the social context of vulnerable populations.
分析1980 - 2021年巴西米纳斯吉拉斯州中风死亡率的时空演变。
采用按微区域汇总数据的生态研究。分段线性回归用于趋势分析;每五年的发病率地图和扫描统计用于空间分析。
有392,521例与中风相关的死亡(发病率为52.6/10万·年)。所有发病率(粗发病率、调整发病率、按年龄组划分的发病率)均呈下降趋势,粗发病率下降幅度较小(年变化百分比[APC]= -0.70),20 - 39岁年龄组下降更快(APC = -4.48)。在南部地区发现一个高发病率集群(1980 - 1999年;相对风险[RR]= 2.06),在西北部发现一个低发病率集群(2008 - 2021年;RR = 0.59)。下降最显著的是南部地区(APC = -3.64)。
中风死亡率呈下降趋势。近年来在东北部发现的高发病率集群和地区需要服务管理者予以关注。
中风死亡率呈下降趋势,在南部发现一个高发病率集群(1980 - 1999年;相对风险[RR]= 2.06),在西北部发现另一个低发病率集群(2008 - 2021年;RR = 0.59)。
对于卫生服务管理者而言,建议对近年来中风死亡率较高的东北部微区域和相应城市给予更多关注,以改善医疗服务监管和网络监管,并优化这些服务的可及性。
有必要监测中风死亡率的时空演变,并开展不同规模(例如市级规模)和方法(例如多层次分析)的新研究,以估计危险因素和弱势群体的社会背景。