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

<div><p>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.</p></div

Modified Rankin Scale (mRS) scores of 27 first-ever sub-arachnoid haemorrages stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Evolution of functional status of 407 patients with all stroke types measured by Rankin scale over 3-years.

<p>Evolution of functional status of 407 patients with all stroke types measured by Rankin scale over 3-years.</p

Modified Rankin Scale (mRS) scores of 37 first-ever haemorrhagic stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Risk factors for functional dependence at 12, 24 and 36 months after first-ever IS stroke, adjusted relative risks, 95%confidence intervals and p-values (n = 303).

<p>Risk factors for functional dependence at 12, 24 and 36 months after first-ever IS stroke, adjusted relative risks, 95%confidence intervals and p-values (n = 303).</p

Modified Rankin Scale (mRS) scores of 303 first-ever ischaemic stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Functional status of 303 patients after incident stroke measured by Rankin scale at 30 days and 3 years.

<p>Functional status of 303 patients after incident stroke measured by Rankin scale at 30 days and 3 years.</p

Baseline characteristics of patients, risk factors, clinical severity and diagnosis.

<p>Baseline characteristics of patients, risk factors, clinical severity and diagnosis.</p