Minelli Cesar, Chiozzini Esther Maria Langhi, Ujikawa Liliana Tiene, Reis Geraldo Cassio Dos, Camilo Millene Rodrigues, Pontes-Neto Octavio Marques
Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
Hospital Carlos Fernando Malzoni, Departamento de Neurologia, Matão SP, Brazil.
Arq Neuropsiquiatr. 2025 Feb;83(2):1-7. doi: 10.1055/s-0045-1804924. Epub 2025 Mar 19.
The data on predictors of poor outcomes for stroke patients in middle-income countries are lacking.
To identify in the acute phase after a first-ever stroke (FES) predictors of a poor outcome within 3 months and 1 year in a population-based study in the town of Matão, state of São Paulo, Brazil.
We prospectively investigated the characteristics of patients with FES in Matão, from a prospective study, in a population-based stroke registry, from 2015 to 2020. Poor outcome was defined as a modified Rankin scale (mRS) score of 3 to 6, assessed at 3 months and 1 year of follow-up. The association between predictors and poor outcome was analyzed by logistic regression analysis.
Of the 783 patients, the final sample consisted of 378 subjects for analysis. The mean age was 69.2(± 14.3) years, and 43.1% of patients were female. At 3 months and 1 year after a FES, 50.4% and 47.1% of stroke patients were classified as poor prognosis, respectively. Older age, female gender, hemiplegia, aphasia, subarachnoid hemorrhage, and comorbidities present in the acute phase were the predictors associated with a poor outcome.
Non-modified and potentially modified predictors increase the risk of a poor FES prognosis in a population-based study from a middle-income country. Interventions focusing on these target populations and improving access to prevention and stroke management in the acute phase are necessary.
中等收入国家缺乏关于中风患者不良预后预测因素的数据。
在巴西圣保罗州马陶市开展的一项基于人群的研究中,确定首次中风(FES)急性期3个月和1年内不良预后的预测因素。
我们对2015年至2020年马陶市FES患者的特征进行了前瞻性调查,该研究来自一项基于人群的中风登记研究。不良预后定义为随访3个月和1年时改良Rankin量表(mRS)评分为3至6分。通过逻辑回归分析预测因素与不良预后之间的关联。
在783例患者中,最终样本包括378例用于分析的受试者。平均年龄为69.2(±14.3)岁,43.1%的患者为女性。FES后3个月和1年时,分别有50.4%和47.1%的中风患者被归类为预后不良。年龄较大、女性、偏瘫、失语、蛛网膜下腔出血以及急性期存在的合并症是与不良预后相关的预测因素。
在一项来自中等收入国家的基于人群的研究中,未改变和潜在可改变的预测因素会增加FES预后不良的风险。有必要针对这些目标人群进行干预,并在急性期改善预防和中风管理的可及性。