Trends in stroke incidence, mortality and case fatality rates in Joinville, Brazil: 1995–2006
- N L Cabral1,
- A R R Gonçalves1,
- A L Longo1,
- C H C Moro1,
- G Costa1,
- C H Amaral1,
- M V Souza1,
- J Eluf-Neto2,
- L Augusto M Fonseca2
- 1Department of Medicine of the Universidade da Região de Joinville, Joinville, Brazil and São José Municipal Hospital, Joinville, Brazil
- 2Department of Preventive Medicine Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Professor N L Cabral, Clinica Neurológica de Joinville, Rua Plácido O de Oliveira, 1244, CEP 892-02451, Joinville, Santa Catarina, Brazil; nlcabral{at}terra.com.br
- Received 4 October 2008
- Revised 2 December 2008
- Accepted 4 December 2008
- Published Online First 15 January 2009
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.
Footnotes
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Competing interests: None.
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Funding: This study received financial support from the Fundação de Amparo à Pesquisa do Estado de Santa Catarina, the Universidade Regional de Joinville and the Joinville Municipal Health Department and grant support from Fundação de Apoio à Pesquisa Cientifica do Estado de Santa Catarina-FAPESC. The sponsor had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all of the data in the study and had the final responsibility for the decision to submit for publication.
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Ethics approval: The study was approved by the ethics in research committees of the hospitals and universities involved.
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See Editorial Commentary, p 705
