Public hospitalizations for stroke in Brazil from 2009 to 2016

Dantas, Leila Figueiredo; Marchesi, Janaina Figueira; Peres, Igor Tona; Hamacher, Śılvio; Bozza, Fernando A.; Neira, Ricardo Alfredo Quintano

doi:10.1371/journal.pone.0213837

Cited by 29 publications

(40 citation statements)

References 27 publications

(38 reference statements)

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“…In Brazil, stroke was responsible for 10.18% of all deaths in the country in 2009 and the fourth leading cause of years of life lost in 2016 [17]. Although a study in public hospitals in our country has registered a decrease in intra-hospital mortality in recent years [17].…”

Section: Discussionmentioning

confidence: 80%

In-Hospital Mortality From Cerebrovascular Disease

Fustes

Rodriguez

Fustes³

2020

Cureus

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IntroductionCerebrovascular disease (CVD) is the second most common cause of death. Despite the advances made in recent years with the introduction of specific treatment units and thrombolytics, CVD remains the leading cause of neurological hospitalization and adult disability. ObjectiveOur objective is to determine the frequency and causes of early mortality, during hospitalization, of patients with acute CVD. MethodsWe conducted a retrospective, descriptive study of 704 patients treated for acute CVD at the Neurology Service of the Hospital in Curitiba, Brazil, over a period of three years, to whom the CVD Program protocol was applied. We checked the conditions at hospital discharge, obtaining the mortality rate and its causes. ResultsWe studied 463 men and 241 women, over 14 years of age with an average of 64 years; 57 patients died. Of the 614 with ischemic CVD, nine males and four females died, establishing a mortality rate of 1.9%. Of the 90 patients with hemorrhagic CVD, 44 died: 26 male and 18 female. The main causes of death were arrhythmias, pneumonia with acute respiratory failure, acute myocardial infarction, and multiple organ failure. ConclusionWe found no relationship between mortality and specific risk factors, except for age over 65 years. The low rate of deaths obtained in ischemic stroke reflects the multidisciplinary work involved in caring for patients with cerebrovascular disease in our center, which allows us to obtain results as low in mortality as those described in the literature.

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Section: Discussionmentioning

confidence: 80%

In-Hospital Mortality From Cerebrovascular Disease

Fustes

Rodriguez

Fustes³

2020

Cureus

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“…Data from studies on stroke incidence in Brazil and globally agree that the age-standardized incidence and mortality have decreased over the last decades. 7,12 On the other hand, the number of hospitalizations have increased, indicating a growing burden of stroke on populations from developed and developing countries. In addition, we observed significant seasonal variation in age-adjusted stroke-related hospitalizations in Brazil.…”

Section: Discussionmentioning

confidence: 99%

“…We included adult patients (over 20 years old) hospitalized with stroke diagnosis codes (ICD codes I60, I61, I63 and I64—Supplementary Table 1). 7 As outcomes, we identified the patient’s ages at time of stroke and calculated the monthly rates of hospitalization per 100,000 inhabitants using age-adjustment via direct standardization. 8 Also, we considered the temperature per month as the median of the hourly average air temperature values for the whole country and each region.…”

Section: Methodsmentioning

confidence: 99%

Effect of seasonal and temperature variation on hospitalizations for stroke over a 10-year period in Brazil

Kurtz

Bastos

Aguilar

et al. 2020

International Journal of Stroke

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Background Seasonal variation in stroke incidence remains controversial. Aims We aimed to describe the pattern of seasonality in hospitalizations for stroke in Brazil. Methods We evaluated age-adjusted hospitalization rates for stroke per month using data from the Brazilian Unified Healthcare System and median monthly temperature data obtained from the National Institute of Meteorology. To detect a seasonality pattern in time series, we used seasonal-trend decomposition using LOESS. We calculated a seasonal strength statistic and used Kruskal–Wallis test to evaluate the presence of seasonality in Brazil and its five regions. We also assessed the association of temperature and stroke hospitalization rates using Spearman’s rho correlation. Results We identified 1,422,496 stroke-related hospitalizations between 2009 and 2018. Mean age was 67 years, 51% were male and 77.5% of stroke diagnoses were not specified as ischemic or hemorrhagic. Median temperature was 23.8℃ (IQR 22.3–24.4). Age-adjusted hospitalizations demonstrated significant seasonal variation during all the years analyzed, with increased rates during the winter. When regional differences were analyzed, seasonal behavior was present in the south, southeast and northeast regions of the country. These were also the regions with lower median temperatures during the winter months and greater amplitude of average temperatures between warmer and colder months. Conclusions In this large national cohort of stroke patients in Brazil, we demonstrated the presence of seasonal variation in the age-adjusted hospitalization rate, with peak rates during the winter months. The regional gradient of incidence of stroke was directly associated with colder winters and greater amplitude of temperature.

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“…Another paper 24 found a report of previous stroke in 20% of the patients admitted post-stroke in a public hospital. Between 2009 and 2016, the elderly were responsible for the highest rates of hospitalization and mortality by stroke in Brazilian public hospitals 25 . In Brazil, the incidence of hemorrhagic stroke is of approximately 26%, while 73% are of the ischemic type.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia and its relation with nutritional status and calorie/protein intake in the elderly

et al. 2019

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Purpose: to evaluate the nutritional status associated with dysphagia, and compare the calorie and protein intake of dysphagic elderly patients to that of non dysphagic ones, during hospitalization. Methods: this is a cross-sectional study with elderly people ranging from 60 to 80 years old admitted as inpatients in a medical and neurological clinic of a public hospital. They formed two groups, according to the presence of dysphagia: dysphagic and non dysphagic ones. The inclusion criteria were: dysphagia secondary to stroke and exclusive oral feeding. Anthropometric measurements and the Mini-Nutritional Assessment (MNA) were applied. The 24-hour recall was used to analyze food consumption. The statistical analysis used the Fisher's exact test for the association of variables, and the Mann-Whitney test, for their comparison. Results: a total of 12 elderly people participated, whose mean age was 70.50 ± 7.77 years in the dysphagia group (n = 6), and 72.67 ± 5.01 years in the non dysphagia group (n = 6).There was an association between the presence of dysphagia and the risk of malnutrition, according to MNA (p = 0.028). No significant difference in calorie and protein intake was seen between the groups. The group with dysphagia had a lower water intake as compared to the non dysphagia group (p = 0.045). Conclusion: dysphagia was associated with the risk of malnutrition and lower fluid intake in dysphagic patients, thus, increasing their risk of dehydration.

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Public hospitalizations for stroke in Brazil from 2009 to 2016

Cited by 29 publications

References 27 publications

In-Hospital Mortality From Cerebrovascular Disease

In-Hospital Mortality From Cerebrovascular Disease

Effect of seasonal and temperature variation on hospitalizations for stroke over a 10-year period in Brazil

Dysphagia and its relation with nutritional status and calorie/protein intake in the elderly

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