Mortality from cerebral stroke in the State of Pernambuco, Brazil: an ecological study

Abstract

Introduction: cerebrovascular accident (CVA) is the second leading cause of death globally, characterized by cerebrovascular events due to dysfunctions in the cerebral blood supply. It can be ischemic or hemorrhagic and has high morbidity and mortality rates. In Brazil, it is the main cause of death, disabling many over 50 years of age and leading to around 40% of early retirements. Despite advances in initial treatment, mortality rates remain high, indicating flaws in prevention and treatment strategies. Therefore, the World Health Organization (WHO) emphasizes the need for immediate implementation of preventive and treatment measures for this condition. Objective: to evaluate the trend in the mortality coefficient and proportional mortality from stroke in the population of Pernambuco, from 2000 to 2021. Methods: This is an ecological time series study with data from the population of the state of Pernambuco, located in northeast region of Brazil, from 2000 to 2021. The eligibility criteria were deaths with a stroke occurring in the state of Pernambuco. Information on mortality, population estimates and number of deaths by sex and age group were extracted from the database of the Department of Informatics of the Unified Health System (DATASUS). For statistical analysis, it was calculated the mortality coefficient, proportional mortality, mean, standard deviation, skewness and kurtosis. The temporal trend of stroke was assessed by jointpoint regression. Results: Between 2000 and 2021, there were 39,410 deaths from stroke. Around 49.0% were male and 51.0% female. The female sex had an average of 913.45 in the number of deaths, being quantitatively higher than the average identified for the male sex of 877.04 deaths. The years with the highest number of deaths were 2006, 2007 and 2008, while 2018 had the lowest number. There was a progressive increase in the number of deaths from stroke from 2018 to 2021. There was a decline in the average annual percentage variation in the mortality rate for stroke in all groups studied, in addition to a drop in the average annual percentage of proportional mortality for stroke in the entire population. Throughout the period, there was a decline in the average annual percentage of proportional mortality from stroke in the entire population studied. Conclusion: In the period from 2000 to 2021 there was a greater number of deaths due to stroke in women in contrast to men in the population of Pernambuco, Brazil. Furthermore, there was a downward trend in stroke rates in both the mortality rate and proportional mortality. In the period from 2018 to 2021 there was a progressive increase in the mortality rate and proportional mortality from stroke.