Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional

Cabral, Norberto L.; Longo, Alexandre L.; Moro, Carla H. C.; Amaral, Cláudio H.; Kiss, Haydee C.

doi:10.1590/S0004-282X1997000300002

Resumos

A carência de dados epidemiológicos e a impressão prévia de elevada incidência de acidente vascular cerebral (AVC) no Brasil criou o estímulo para estudo institucional prospectivo em Joinville. No período de 1-março-1995 a 1-março-1996, avaliamos o primeiro episódio e episódios recorrentes em AVC, incidência, mortalidade, taxa de fatalidade-caso em 30 dias (letalidade), freqüência de fatores de risco, tempo para admissão hospitalar e distribuição dos infartos cerebrais por subtipos patológicos. Registramos 429 pacientes no período, 320 destes com primeiro episódio. Tomografia de crânio foi realizada em 98% dos casos. A taxa de incidência anual ajustada por idade em primeiro episódio de AVC foi de 156/100000. A distribuição por diagnóstico foi: 73,4% para infarto cerebral, 18.4% para hemorragia cerebral e 7,5% para hemorragia subaracnóide. A taxa de mortalidade anual padronizada foi 25/100000. A letalidade foi 26%. Hipertensão, AVC prévio e diabetes foram os fatores de risco mais freqüentes. Somente 25% dos pacientes chegaram ao hospital nas primeiras três horas iniciais. Concluímos que a taxa de incidência em primeiro episódio de AVC em pacientes institucionalizados em Joinville, Brasil, é elevada. A taxa de mortalidade e letalidade são similares as de outras populações.

doença cerebrovascular; acidente vascular cerebral; epidemiologia; incidência; etiologia; taxas de mortalidade

The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with the objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case rate (in 30 days letality), frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients were submited to at least one computed tomography scanning. The episodes of cerebral infarcts were divided in pathological sub-types. Results showed that the annual incidence adjusted to the age of first stroke episode was 156/100000. The distribution by diagnosis was: 73.4% for cerebral infarct, 18.4% for cerebral hemorrhage and 7.5% for subarachnoid hemorrhage. The annual standard mortality rate was 25/100000. The fatality case global rate in 30 days was 26%. Hypertension, previous stroke and diabetes were the most frequent risk factors. Only 25% of the patients were assisted within three hours of the onset of stroke. We concluded that the incidence rate of first episode of stroke is high in institucionalized patients in Joinville, Brazil. The mortality and fatality-case rates are similar to the ones of other populations.

cerebrovascular disease; stroke; epidemiology; incidence; etiology; mortality rates

Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional

Epidemiology of cerebrovascular disease in Joinville, Brazil: an institutional study

Norberto L. Cabral; Alexandre L. Longo; Carla H. C. Moro; Cláudio H. Amaral; Haydee C. Kiss

Neurologistas da Clínica Neurológica de Joinville, SC, Brasil: Membros Efetivos da Academia Brasileira de Neurologia (NLC, ALL, CHCM), Preceptor da Residência Medicina Interna do Hospital São José (NLC), Neurologista do Hospital Dona Helena (ALL), Neurologista do Hospital Regional (CHCM)

RESUMO

A carência de dados epidemiológicos e a impressão prévia de elevada incidência de acidente vascular cerebral (AVC) no Brasil criou o estímulo para estudo institucional prospectivo em Joinville. No período de 1-março-1995 a 1-março-1996, avaliamos o primeiro episódio e episódios recorrentes em AVC, incidência, mortalidade, taxa de fatalidade-caso em 30 dias (letalidade), freqüência de fatores de risco, tempo para admissão hospitalar e distribuição dos infartos cerebrais por subtipos patológicos. Registramos 429 pacientes no período, 320 destes com primeiro episódio. Tomografia de crânio foi realizada em 98% dos casos. A taxa de incidência anual ajustada por idade em primeiro episódio de AVC foi de 156/100000. A distribuição por diagnóstico foi: 73,4% para infarto cerebral, 18.4% para hemorragia cerebral e 7,5% para hemorragia subaracnóide. A taxa de mortalidade anual padronizada foi 25/100000. A letalidade foi 26%. Hipertensão, AVC prévio e diabetes foram os fatores de risco mais freqüentes. Somente 25% dos pacientes chegaram ao hospital nas primeiras três horas iniciais. Concluímos que a taxa de incidência em primeiro episódio de AVC em pacientes institucionalizados em Joinville, Brasil, é elevada. A taxa de mortalidade e letalidade são similares as de outras populações.

Palavras-chave: doença cerebrovascular, acidente vascular cerebral, epidemiologia, incidência, etiologia, taxas de mortalidade.

ABSTRACT

The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with the objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case rate (in 30 days letality), frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients were submited to at least one computed tomography scanning. The episodes of cerebral infarcts were divided in pathological sub-types. Results showed that the annual incidence adjusted to the age of first stroke episode was 156/100000. The distribution by diagnosis was: 73.4% for cerebral infarct, 18.4% for cerebral hemorrhage and 7.5% for subarachnoid hemorrhage. The annual standard mortality rate was 25/100000. The fatality case global rate in 30 days was 26%. Hypertension, previous stroke and diabetes were the most frequent risk factors. Only 25% of the patients were assisted within three hours of the onset of stroke. We concluded that the incidence rate of first episode of stroke is high in institucionalized patients in Joinville, Brazil. The mortality and fatality-case rates are similar to the ones of other populations.

Key words: cerebrovascular disease, stroke, epidemiology, incidence, etiology, mortality rates.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 7-março-1997.

Dr. Norberto Luiz Cabral - Rua Plácido Olímpio Oliveira 1244 - 89202-451 Joinville SC - Brasil. FAX 047 437 2525.

1. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE III, the TOAST Investigators. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trich. Stroke 1993;24:33-41.
2. Alter M, Zhang ZX, Sobel E, Fisher M, Davanipour Z, Friday G. Standartized ratios os stroke: a worldwide review. Neuroepidemiology 1986;5:148-158.
3. Bamford J, Dennis M, Sandercock P, Burn J, Warlow C. The frequency, causes and timing of death within 30 days of first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg and Psychiatry 1990;53:824-829.
4. Bonita R. Epidemiology of stroke. Lancet 1992;339:342-344.
5. Bonita R, Beaglehole R. In: Wishnant JP (ed). Stroke: populations, cohorts and clinical trial. Oxoford: Butherworth-Heinemann, England, 1996:59-78.
6. Bonita R, Beaglehole R, Norlh Jd. Event, incidence and case fatality rates of cerebrovascular disease in Auckland, New Zeland. Am J Epidemiol 1984;120:236-243.
7. Feigin VL, Wiebers DO, Nikitin YP, O'Fallon WN, Whisnant JP. Stroke epidemiology in Novosibirsk, Russia: a population-based study. Mayo Clin Proc 1995;70:847-852.
8. Fernandes JG. Fatores de risco e declínio das doenças cerebrovasculares. R.Med PUCRS 1988;1:7-13.
9. Gross CR, Kase CS, Mohr JP, Cunninghan SC and Baker WE. Stroke in South Alabama: incidence and diagnostic features-a population based study. Stroke 1984;15:249-255.
10. Kunitz SC, Gross CR, Heyman A, Kase CS, Mohr JP, Price TR, Wolf PA. The Pilot Stroke Data Bank: definition, design, and data. Stroke 1984;15:740-746.
11. Lessa I, Bastos CAG. Epidemiologia dos acidentes vasculares encefálicos na cidade de Salvador, Bahia, Brasil. Boi Oficina Sanit Panam 1984;95:404-416.
12. National Institute of Neurological Disorders and Stroke ad Hoc Committee. Classification of cerebrovascular diseases III. Stroke 1990;21:637-676.
13. Rowe CC, Donnan GA, Bladion PF. Intracerebral haemorrhage: incidence and use of computed tomography. BMJ 1988;297:1177-1178.
¹⁴
Secretaria Estadual de Saúde Santa Catarina. M.med. Sem data. População estimada segundo idade e sexo. Joinville. AMUNESC-13° Regional. IBGE Censo demográfico. 1991 (método aibi), 1996.
15. Silver FL, Norris JW, Lewis AJ, Hachinski VC. Early mortality following stroke: a prospective review. Stroke 1984;15:492-496.
16. Terént A. Stroke morbidity. In: Stroke: In: Wishnant JP (ed). Stroke: populations, cohorts and clinical trial. Oxoford: Butherworth-Heinemann, England, 1993;37-58.
17. Ward G, Jamrozik K. Stewart-Wyne, E. Incidence and outcome of cerebrovascular disease in Perth, Wertern Australia. Stroke 1988;19:1501-1506.
18. Waterhouse J, Muir C, Correa T, Powell J. Cancer incidence in five continents. Lyon: France, International Agency for Research on Cancer, 1976;3:456.
19. Working Group in Emergency Brain Resuscitation. Emergency brain resuscitation. Ann Intern Med 1995;122:622-627.

Datas de Publicação

Publicação nesta coleção
18 Out 2010
Data do Fascículo
Set 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE III, the TOAST Investigators. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trich. Stroke 1993;24:33-41.

[2] 2. Alter M, Zhang ZX, Sobel E, Fisher M, Davanipour Z, Friday G. Standartized ratios os stroke: a worldwide review. Neuroepidemiology 1986;5:148-158.

[3] 3. Bamford J, Dennis M, Sandercock P, Burn J, Warlow C. The frequency, causes and timing of death within 30 days of first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg and Psychiatry 1990;53:824-829.

[4] 4. Bonita R. Epidemiology of stroke. Lancet 1992;339:342-344.

[5] 5. Bonita R, Beaglehole R. In: Wishnant JP (ed). Stroke: populations, cohorts and clinical trial. Oxoford: Butherworth-Heinemann, England, 1996:59-78.

[6] 6. Bonita R, Beaglehole R, Norlh Jd. Event, incidence and case fatality rates of cerebrovascular disease in Auckland, New Zeland. Am J Epidemiol 1984;120:236-243.

[7] 7. Feigin VL, Wiebers DO, Nikitin YP, O'Fallon WN, Whisnant JP. Stroke epidemiology in Novosibirsk, Russia: a population-based study. Mayo Clin Proc 1995;70:847-852.

[8] 8. Fernandes JG. Fatores de risco e declínio das doenças cerebrovasculares. R.Med PUCRS 1988;1:7-13.

[9] 9. Gross CR, Kase CS, Mohr JP, Cunninghan SC and Baker WE. Stroke in South Alabama: incidence and diagnostic features-a population based study. Stroke 1984;15:249-255.

[10] 10. Kunitz SC, Gross CR, Heyman A, Kase CS, Mohr JP, Price TR, Wolf PA. The Pilot Stroke Data Bank: definition, design, and data. Stroke 1984;15:740-746.

[11] 11. Lessa I, Bastos CAG. Epidemiologia dos acidentes vasculares encefálicos na cidade de Salvador, Bahia, Brasil. Boi Oficina Sanit Panam 1984;95:404-416.

[12] 12. National Institute of Neurological Disorders and Stroke ad Hoc Committee. Classification of cerebrovascular diseases III. Stroke 1990;21:637-676.

[13] 13. Rowe CC, Donnan GA, Bladion PF. Intracerebral haemorrhage: incidence and use of computed tomography. BMJ 1988;297:1177-1178.

[14] ¹⁴
Secretaria Estadual de Saúde Santa Catarina. M.med. Sem data. População estimada segundo idade e sexo. Joinville. AMUNESC-13° Regional. IBGE Censo demográfico. 1991 (método aibi), 1996.

[15] 15. Silver FL, Norris JW, Lewis AJ, Hachinski VC. Early mortality following stroke: a prospective review. Stroke 1984;15:492-496.

[16] 16. Terént A. Stroke morbidity. In: Stroke: In: Wishnant JP (ed). Stroke: populations, cohorts and clinical trial. Oxoford: Butherworth-Heinemann, England, 1993;37-58.

[17] 17. Ward G, Jamrozik K. Stewart-Wyne, E. Incidence and outcome of cerebrovascular disease in Perth, Wertern Australia. Stroke 1988;19:1501-1506.

[18] 18. Waterhouse J, Muir C, Correa T, Powell J. Cancer incidence in five continents. Lyon: France, International Agency for Research on Cancer, 1976;3:456.

[19] 19. Working Group in Emergency Brain Resuscitation. Emergency brain resuscitation. Ann Intern Med 1995;122:622-627.