Prognostic factors related to neurological disability after the implementation of the first stroke unit in a remote region of Brazil.

Authors

Ana Rosa Ribeiro Fonseca, Allex Jardim da Fonseca, Lívia Maria da Silva Martins, Caio Cayres de Queiroz, Joab Ferreira de Oliveira Júnior, Ananda de Melo Albuquerque, Kelven Henrique Silva de Sousa, Raquel Gaio de Matos, Gustavo Procópio Silva, Ruan Lucas de Almeida Mangueira, André Machado de Siqueira

Published in

Arquivos de neuro-psiquiatria. Volume 84. Issue 9. Pages 1-10. Epub Aug 31, 2026.

Abstract

Stroke is the main public health problem in Brazil.
To evaluate the incidence of moderate-to-severe disability in patients admitted to the Stroke Unit in Roraima (2024), and estimate the impact of Stroke Unit implementation on neurological outcomes compared with historical data.
This hospital-based observational cohort study assessed factors associated with moderate-to-severe disability in patients admitted to the Stroke Unit. Clinical and sociodemographic data were collected using a semistructured questionnaire. Participants were evaluated daily until discharge or death using the National Institutes of Health stroke scale (NIHSS).
A total of 400 patients was included. Mean age was 64.2 ± 15.8 years, and 52% of patients were male. Most cases were of ischemic stroke (82.2%), followed by wake-up stroke (13%), transient ischemic attack (TIA: 10%), and hemorrhagic stroke (1%). Systemic arterial hypertension (SAH: 57.1%), and diabetes (33.1%) were the most frequent comorbidities. Nearly 80% of patients were discharged, and the mortality rate was 3.7%. According to the modified Rankin Scale (mRS), moderate-to-severe disability at day 90 was associated with age > 70 years (RR = 1.45; 95% CI = 1.02-4.53), previous stroke (RR = 1.35; 95% CI = 1.12-3.42), and structural heart disease (RR = 1.80; 95% CI = 1.23-3.28). Thrombolytic therapy was performed in 12.5% of cases and reduced moderate-to-severe sequelae by 50%.
Stroke Unit implementation represented a significant advance in stroke care in Roraima, reducing sequelae severity and mortality, including among older patients. However, access to thrombolytic therapy remains limited due to delayed hospital admission.

PMID:
42674467
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.

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