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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2022; 80(06): 550-556
DOI: 10.1590/0004-282X-ANP-2021-0194
Article

Stroke in the state of Alagoas, Brazil: a descriptive analysis of a northeastern scenario

Acidente vascular cerebral no estado de Alagoas, Brasil: análise descritiva de um cenário do nordeste brasileiro
Letícia Januzi de Almeida Rocha 
1   Universidade Federal de Alagoas, Faculdade de Medicina, Maceió AL, Brazil.
,
Kauan Araújo da Silva 
1   Universidade Federal de Alagoas, Faculdade de Medicina, Maceió AL, Brazil.
,
Arthur de Lima Chagas 
1   Universidade Federal de Alagoas, Faculdade de Medicina, Maceió AL, Brazil.
,
Arthur de Oliveira Veras 
1   Universidade Federal de Alagoas, Faculdade de Medicina, Maceió AL, Brazil.
,
Vitor Gustavo Leão Souto 
1   Universidade Federal de Alagoas, Faculdade de Medicina, Maceió AL, Brazil.
,
Maria Clara Motta Barbosa Valente 
2   Universidade Estadual de Ciências da Saúde de Alagoas, Maceió AL, Brazil.
,
Jussara Almeida de Oliveira Baggio 
3   Universidade Federal de Alagoas, Curso de Medicina, Arapiraca AL, Brazil.
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ABSTRACT

Background There is little information available on stroke epidemiology in the northeast of Brazil. Objective Our objective was to investigate the prevalence of the stroke subtypes, prevalence of cerebrovascular risk factors and patterns of management in a public neurovascular outpatient referral service, in Alagoas. Methods Data were prospectively collected from consecutive patients with stroke who were treated in a specialized neurovascular clinic between November 2016 and June 2018. Recurrence was evaluated by telephone 12 months after patients had been included in the study. Results We evaluated 190 patients (mean age, 60.22 ( 13.29 years; 60.5% males). Ischemic stroke was the most frequent subtype (85.2%). Sedentary lifestyle was the most common risk factor (71.6%), followed by hypertension (62.6%) and stroke family history (41.1%). Only 21.5% of the patients were transported by ambulance to the hospital, and 42.6% received medical support in hospital units or emergency units with no imaging support. The median NIHSS was 2.5 (IQR, 1-5) and mRS was 2 (IQR, 1-3). We found a high rate of undetermined stroke (35.8%), and few patients completed the etiological investigation. One year after inclusion in the study, 12 patients (6.3%) had died and 14 (7.3%) had had another stroke. Conclusions The prevalence of cerebrovascular risk factors and clinical presentation were similar to what had been seen in previous series. A notable number of patients received medical support in institutions with no imaging equipment. The high number of cases of undetermined stroke etiology shows the difficulty in accessing healthcare services in Alagoas.

RESUMO

Antecedentes Até o momento existe pouca informação disponível na literatura sobre a epidemiologia do acidente vascular verebral (AVC) no nordeste brasileiro. Objetivo Investigar a prevalência dos subtipos de AVC, dos fatores de risco para doenças cerebrovasculares e o manejo do AVC em um serviço público especializado em Alagoas. Método Os dados foram coletados de forma prospectiva e consecutiva de pacientes com diagnóstico de AVC em um ambulatório especializado em neurovascular, de novembro de 2016 a junho de 2018. Recorrência do AVC foi avaliada por telefone 12 meses após a inclusão no estudo. Resultados Foram avaliados 190 pacientes, idade média de 60,22(13,29 anos, 60,5% homens. AVC isquêmico foi o subtipo mais comum (85,2%). Sedentarismo foi o fator de risco mais prevalente (71,6%), seguido de hipertensão (62,6%) e história familial de AVC (41,1%). Somente 21,5% dos pacientes foram transportados por ambulância até o hospital e 42,6% receberam o primeiro atendimento em serviço médico sem suporte de exame de imagem. A mediana do NIHSS foi 2,5 (IQR, 1-3). Encontramos alta prevalência de AVC indeterminado (35,8%) e poucos pacientes completaram a investigação etiológica. Após um ano da inclusão no estudo, 12 pacientes (6,3%) morreram e 14 (7,3%) tiveram outro AVC. Conclusão A prevalência dos fatores de risco para doenças cerebrovasculares e a apresentação clínica foram similares a séries prévias. Um número expressivo de pacientes recebeu atendimento médico em locais sem exames de imagem. Houve alto número de pacientes com AVC indeterminado, o que mostra a dificuldade de acesso ao sistema de saúde em Alagoas.

Keywords:

Stroke - Epidemiology - Risk Factors - Functional Status

Palavras-chave:

Acidente Vascular Cerebral - Epidemiologia - Fatores de Risco - Estado Funcional

Authors’ contributions:

LJAR: conceptualization, formal analysis, investigation, methodology, project administration, writing-original draft, writing-review and editing; KAS, ALC, AOV, VGLS, MCMBV: data curation, formal analysis, investigation, methodology; JAOB: conceptualization, data curation, formal analysis, investigation, methodology, writing-original draft, writing-review and editing.


Support

Fellowships for undergraduate students at UFAL (Federal University of Alagoas).




Publication History

Received: 16 May 2021

Accepted: 06 August 2021

Article published online:
06 February 2023

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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