Associação entre escores de índice de desenvolvimento humano (IDH) e recorrência de acidente vascular cerebral em municípios da Bahia

Abstract

Background: In Brazil, stroke has been the leading cause of death in the last twenty years. Despite the numerous studies on stroke recurrence, there are still few studies aimed at understanding demographic factors possibly involved with the recurrence of events in order to conduct targeted prevention. Objective: To evaluate the association between the municipal Human Development Indexes of the cities of Bahia and stroke recurrence in patients followed in a specialized outpatient clinic. Methods: A cross-sectional study in patients with a history of ischemic or hemorrhagic stroke or TIA (transient ischemic attack), who were 18 years of age or older. Data were collected by a standardized form through review of medical records or interviews. Analyzes were performed by SPSS program version 21.0. Statistical significance was considered as p <0.05. Results: Data were collected from 237 patients (mean age 58.3 ± 15.3), of which 53.2% were female. Ischemic stroke or TIA occurred in 92% and hemorrhagic stroke 8%. In 60 patients (27.6%) there was recurrence. Mean age was higher in the group with recurrence (p = 0.031). High municipal HDI (p = 0.011), hypertension (p < 0.001), diabetes mellitus (p = 0.024), dyslipidemia (p = 0.036), coronary artery disease (p = 0.001) and smoking (p = 0.044) were shown to be associated with recurrence of stroke. In the multivariate model, only Chagas disease (Wald = 3.85, 95% CI = 1.002 - 8.960, p <0.05) was independently associated with recurrence of stroke. Conclusions: Patients with recurrent stroke were from cities with higher HDI, were older, more hypertensive, diabetic, dyslipidemic, bearer of coronary artery disease and smokers than patients without recurrence. Chagas disease was an independent predictor of stroke recurrence in this population.