%0 Journal Article
%T Outcome Determinants of Stroke in a Brazilian Primary Stroke Center
%A Gustavo W. Kuster
%A L¨ªvia A. Dutra
%A Israel P. Brasil
%A Evelyn P. Pacheco
%A M¨¢rcio A. C. Arruda
%A Cristiane Volcov
%A Renan B. Domingues
%J Stroke Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/194768
%X Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in S£¿o Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS), transient ischemic attack (TIA), and intracerebral hemorrhage (ICH) admitted at ¡°Hospital Paulistano,¡± S£¿o Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil. 1. Introduction Stroke is the first cause of disability, the second cause of cognitive impairment, and the third cause of death in the world [1]. Two-thirds of all stroke deaths occur in low- and middle-income countries, including Latin America countries; however, stroke has been poorly studied in these regions [2]. In Brazil, the largest country in the region, stroke is the leading cause of death and disability and the stroke mortality is one of the highest among Western countries [3, 4]. The causes of the high stroke burden in Brazil remain speculative. One possibility is that the prevalence of stroke is higher in Brazil than in other regions. Some prevalence studies were carried in Brazil but the data are not sufficient to provide an overview of stroke prevalence in Brazil, since most of these studies were carried out in specific regions that do not necessarily reflect the whole country reality [5]. Other potential explanations rely on medical assistance deficiencies, mostly driven by socioeconomic inequality. In fact, previous studies showed that the majority of patients are assisted in public hospitals where diagnostic and therapeutic resources are scarce [6¨C9]. However, the negative impact of these discrepancies on stroke outcome in
%U http://www.hindawi.com/journals/srt/2014/194768/