# Predictors of poor outcome in the acute phase after a first-ever stroke in a population-based study in Matão, Brazil

## TL;DR

This study identifies factors that predict poor outcomes after a first stroke in a Brazilian town, highlighting the need for better stroke care in middle-income countries.

## Contribution

The study provides population-based evidence on stroke outcome predictors in a middle-income country context.

## Key findings

- Older age, female gender, and acute phase comorbidities were linked to poor stroke outcomes.
- Hemiplegia, aphasia, and subarachnoid hemorrhage were significant predictors of poor prognosis.
- Poor outcomes were observed in over 47% of patients at 1 year post-stroke.

## Abstract

Background
 The data on predictors of poor outcomes for stroke patients in middle-income countries are lacking.

Objective
 To identify in the acute phase after a first-ever stroke (FES) predictors of a poor outcome within 3 months and 1 year in a population-based study in the town of Matão, state of São Paulo, Brazil.

Methods
 We prospectively investigated the characteristics of patients with FES in Matão, from a prospective study, in a population-based stroke registry, from 2015 to 2020. Poor outcome was defined as a modified Rankin scale (mRS) score of 3 to 6, assessed at 3 months and 1 year of follow-up. The association between predictors and poor outcome was analyzed by logistic regression analysis.

Results
 Of the 783 patients, the final sample consisted of 378 subjects for analysis. The mean age was 69.2(± 14.3) years, and 43.1% of patients were female. At 3 months and 1 year after a FES, 50.4% and 47.1% of stroke patients were classified as poor prognosis, respectively. Older age, female gender, hemiplegia, aphasia, subarachnoid hemorrhage, and comorbidities present in the acute phase were the predictors associated with a poor outcome.

Conclusion
 Non-modified and potentially modified predictors increase the risk of a poor FES prognosis in a population-based study from a middle-income country. Interventions focusing on these target populations and improving access to prevention and stroke management in the acute phase are necessary.