title: Stroke epidemiology, patterns of management, and outcomes in Fortaleza, Brazil: a hospital-based multicenter prospective study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Hospital Geral de Fortaleza, Fortaleza, Brazil.
authors: João José Freitas
authors: JJ
authors: de Carvalho
authors: Monique Bueno
authors: MB
authors: Alves
authors: Georgiana Álvares Andrade
authors: GÁ
authors: Viana
authors: Cícera Borges
authors: CB
authors: Machado
authors: Bento Fortunato Cardoso
authors: BF
authors: dos Santos
authors: Alberto Hideki
authors: AH
authors: Kanamura
authors: Claudio Luiz
authors: CL
authors: Lottenberg
authors: Miguel Cendoroglo
authors: MC
authors: Neto
authors: Gisele Sampaio
authors: GS
authors: Silva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents