Dados do Trabalho

Título

Mortality and functional status five years after surviving a stroke: a prospective cohort study of 1.005 patients in Fortaleza, Northeast, Brazil

Resumo

Introduction: Stroke is among the leading causes of death and the second most common cause for disability-adjusted life years globally. Over the past decades, mortality related to stroke has decreased globally. The same, however, is not observed regarding impacts on personal, family, social and productive life aspects due to the ensuing disabilities, which remain high. Knowing the survival and disability rates after a stroke helps evaluate the performance of the line of care from primary prevention to pre-hospital and hospital care in the acute setting to rehabilitation and secondary prevention. In addition, it permits having a better understanding of the evolution of the disease and the effects of therapeutic interventions.
Objective: To study the mortality and functional status five years after surviving a stroke in Fortaleza, Northeast Brazil.
Methods: This prospective cohort study was carried out in Fortaleza to analyze patients' survival and functional state five years after a stroke. A translated and culturally adapted Brazilian Portuguese version of the Modified Rankin Scale (mRS) validated to be used over the telephone was adopted to interview 2,214 patients who survived having a stroke between February 3 and December 31, 2014.
Results: From the 3,052 patients investigated by the State Stroke Registry, 838 (27.5%) died while hospitalized. Of these 2,214 survivors, 1,209 patients were excluded (27 refused to participate, 217 did not answer the phone calls, and 961 changed their telephone number). The remaining 1,005 had a mean age of 66.8 ± 14.8 years. After five years, 347 (34.5%) patients had died; 124 (12.3%) did not present any deficit or disability; 116 (11.5%) presented some deficit but no disability, and 88 (8.7%) presented deficits that were considered severe disabilities and were bedridden.
Conclusions: Our data show that five years after surviving a stroke, approximately one-third of patients are independent, one-third rely on assistance for their everyday lives, and one-third are deceased. These numbers are aligned with other studies.
Age above 50 years, previous stroke, and atrial fibrillation were strong poor prognostic predictors, though obesity and dyslipidemia were paradoxically associated with better prognoses.