Trends in Hospitalization and Mortality Among Stroke Patients in a Brazilian Public Hospital: A 16-Year Retrospective Analysis

Tendências de Hospitalização e Mortalidade entre Pacientes com Acidente Vascular Cerebral em um Hospital Público Brasileiro: Uma Análise Retrospectiva de 16 Anos

Resumo

Objective: To assess trends in hospitalization, in-hospital mortality, and thrombolysis rates among stroke patients treated at a Brazilian public hospital over a 16-year period.

Methods: This retrospective observational study analyzed data from 6,203 patients admitted for stroke at the Hospital Estadual Sumaré, São Paulo, between 2006 and 2022. Stroke subtypes, length of hospital stay, thrombolysis rates, and in-hospital mortality were evaluated. Descriptive statistics characterized temporal trends, while multivariate logistic regression identified mortality predictors.

Results: Ischemic stroke was the most prevalent subtype (73.7%), followed by hemorrhagic stroke (19.0%) and subarachnoid hemorrhage (7.3%). The thrombolysis rate increased from 1.2% in 2006 to about 10% in 2022, coinciding with a decline in ischemic stroke mortality from 27.3% to 17.1%. However, hemorrhagic stroke mortality remained high (39.7%). Advanced age (OR = 1.008; 95% CI: 1.005–1.011) and prolonged hospital stay (OR = 1.015; 95% CI: 1.012–1.018) were independent predictors of in-hospital mortality (p<0.001).

Conclusion: This study highlights a significant increase in thrombolysis use within Brazil’s public healthcare system, associated with a progressive decline in ischemic stroke mortality. However, persistently high mortality rates in hemorrhagic stroke cases underscore the need for specialized treatment strategies. These findings provide valuable insights for policymakers to optimize stroke care in Brazil.