title: Trends in stroke incidence, mortality and case fatality rates in Joinville, Brazil: 1995-2006.
abstract: BACKGROUND
  Studying stroke rates in a whole community is a rational way to assess the quality of patient care and primary prevention. However, there are few studies of trends in stroke rates worldwide and none in Brazil.
  
  
  OBJECTIVE
  Established study methods were used to define the rates for first ever stroke in a defined population in Brazil compared with similar data obtained and published in 1995.
  
  
  METHODS
  All stroke cases occurring in the city of Joinville during 2005-2006 were prospectively ascertained. Crude incidence and mortality rates were determined, and age adjusted rates and 30 day case fatality were calculated and compared with the 1995 data.
  
  
  RESULTS
  Of the 1323 stroke cases registered, 759 were first ever strokes. The incidence rate per 100 000 was 105.4 (95% CI 98.0 to 113.2), mortality rate was 23.9 (95% CI 20.4 to 27.8) and the 30 day case fatality was 19.1%. Compared with the 1995 data, we found that the incidence had decreased by 27%, mortality decreased by 37% and the 30 day case fatality decreased by 28%.
  
  
  CONCLUSIONS
  Using defined criteria we showed that in an industrial southern Brazilian city, stroke rates are similar to those from developed countries. A significant decrease in stroke rates over the past decade was also found, suggesting an improvement in primary prevention and inpatient care of stroke patients in Joinville.
authors.affiliation: Clinica Neurológica de Joinville, Rua Plácido O de Oliveira, 1244, CEP 892-02451, Joinville, Santa Catarina, Brazil. cabral@terra.com.br
authors.forename: N L
authors.initials: NL
authors.lastname: Cabral
authors.forename: A R R
authors.initials: AR
authors.lastname: Gonçalves
authors.forename: A L
authors.initials: AL
authors.lastname: Longo
authors.forename: C H C
authors.initials: CH
authors.lastname: Moro
authors.forename: G
authors.initials: G
authors.lastname: Costa
authors.forename: C H
authors.initials: CH
authors.lastname: Amaral
authors.forename: M V
authors.initials: MV
authors.lastname: Souza
authors.forename: J
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: L Augusto M
authors.initials: LA
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D011322:Primary Prevention / Q000639:trends; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult