How Many Patients Become Functionally Dependent after a Stroke? A 3-Year Population-Based Study in Joinville, Brazil

• Published in: PloS one Vol. 12; no. 1; p. e0170204
• Main Authors: de Campos, Lívia Mizuki, Martins, Bruna Mariah, Cabral, Norberto Luiz, Franco, Selma Cristina, Pontes-Neto, Octávio Marques, Mazin, Suleimy Cristina, Dos Reis, Felipe Ibiapina
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20-01-2017; Public Library of Science (PLoS)
• Subjects: Activities of Daily Living; Aged; Brazil - epidemiology; Care and treatment; Classification; Disability; Exercise; Fatalities; Feasibility studies; Female; Follow-Up Studies; Health aspects; Hemorrhage; Hospitals; Humans; Low income groups; Male; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Patient outcomes; Patients; People and places; Population; Population studies; Population Surveillance; Population-based studies; Risk factors; Social Sciences; Stroke; Stroke - epidemiology; Stroke - nursing; Stroke - physiopathology; Stroke patients; Subarachnoid hemorrhage; Trends; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0170204

The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32.7%. Of 303 patients with first-ever ischaemic stroke (IS), one-third were FD at discharge, and 12%, 9% and 8%, respectively at 1, 2 and 3 years. Among 37 patients with haemorrhagic stroke (HS), 38% were dependent at discharge, 16% after 1 and 2 years and 14% after 3. Among 27 patients with subarachnoid haemorrhage (SAH), 19% were dependent at discharge and 4% from 1 to 3 years. Among IS subtypes, cardioembolic ones had the worst risk of FD. (RR 19.8; 95% CI: 2.2 to 175.9). Our results showed that one-third of stroke survivors have FD during the first year after stroke in Brazil. Therefore, a city with half a million people might expect 120 new stroke patients with FD each year.