Incidence of stroke in Cerro Largo, Uruguay. Baseline evaluation before the development of a stroke unit

Abstract

Stroke is the third cause of death in Uruguay. It has been demonstrated that Stroke Units decrea-
se morbimortality due to stroke. Only in recent years, a few of these units have been developed in

Uruguay. Given the temporal limitations of some treatments, regional availability is a key factor.
The aim of the study was to unveil the epidemiology of stroke in the department of Cerro Largo,

Uruguay, to support the development of a local Stroke Unit. A descriptive, prospective study was per-
formed, with a 12 months follow-up of the cohort of the whole population of the department.

Incidence rate was found to be 161,75/100.000 inhabitants/year (137 cases), of which 53.3% were
females. The amount of transient ischemic attacks was 4.3% (6 patients), of ischemic strokes 78.9%
(108) and 23 (16.8%) were brain hemorrhages. Early mortality was 21.9% and it was associated to
hemorrhages.
Among ischemic stroke patients 38 were admitted in the first 3 hours after the onset of symptoms,
while 7 arrived between 3 and 4.5 hours of clinical onset. Combining temporal and severity criteria
(according to NIHSS score), 30% of ischemic stroke patients could have benefited from thrombolytic
therapy, if available.
Stroke incidence was similar to other studies. Our study showed epidemiological and clinical factors

that can be addressed by local dedicated health care policies, including both preventive measures in-
volving the first level of care, and a Stroke Unit with available thrombolytic therapy.