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Incidence of stroke subtypes, prognosis and prevalence of risk factors in Joinville, Brazil: a 2 year community based study
  1. N L Cabral1,
  2. A R R Gonçalves1,
  3. A L Longo1,
  4. C H C Moro1,
  5. G Costa1,
  6. C H Amaral1,
  7. L A M Fonseca2,
  8. J Eluf-Neto2
  1. 1
    Department of Medicine of the Universidade da Região de Joinville, Joinville, Brazil; São José Municipal Hospital, Joinville, Brazil
  2. 2
    Department of Preventive Medicine Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
  1. Professor N L Cabral, Clinica Neurológica de Joinville, Rua Plácido O de Oliveira, 1244, CEP 892-02451, Joinville, Santa Catarina, Brazil; cabral{at}


Background: There have been few population based studies on stroke risk factors and prognosis conducted in Brazil. The objective of this study was to evaluate, over a 2 year period, the incidence of the subtypes of first ever stroke, the prevalence of cardiovascular risk factors and functional prognosis in a city located in the south of Brazil.

Methods: The period from January 2005 to December 2006 was evaluated prospectively by compiling data on first ever stroke cases, medications used prior to the morbidity and the incidence of traditional risk factors. The annual incidence was adjusted for age using the direct method. Patients were monitored for at least 6 months following the event.

Results: Of 1323 stroke cases, 759 were first ever stroke cases. Of these, 610 were classified as infarctions, 94 as intracerebral haemorrhage and 55 as subarachnoid haemorrhage. The crude incidence rate per 100 000 inhabitants was 61.8 for infarction (95% CI 57.0 to 66.9), 9.5 for intracerebral haemorrhage (95% CI 7.7 to 11.6) and 5.6 for subarachnoid haemorrhage (95% CI 4.2 to 7.3). The 30 day case fatality was 19.1%. The most prevalent cardiovascular risk factor was arterial hypertension. By post-stroke month 6, 25% had died (95% CI 21.4 to 29.1) whereas 61.5% had regained their independence (95% CI 56.2 to 68.3).

Conclusions: Case fatality rate, prognosis and incidence adjusted for stroke subtypes were similar to those found in other population based studies. The prevalence rates of ischaemic heart disease, dyslipidaemia, arterial hypertension and diabetes suggest that Joinville presents a mixed pattern of cardiovascular risk, a pattern seen in developed and developing countries alike.

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  • Competing interests: None.

  • Funding: This study received financial support from the Fundação de Amparo à Pesquisa do Estado de Santa Catarina, University of the Region of Joinville and the Joinville Municipal Health Department. Grant support: Fundação de Apoio à Pesquisa Cientifica do Estado de Santa Catarina-FAPESC. University of the Region of Joinville-Univille. 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.

  • Ethics approval: The study was approved by the ethics in research committees of the hospitals and universities involved.