Background and Purpose-Little information exists on the epidemiology and patterns of treatment of patients admitted to Brazilian hospitals with stroke. Our objective was to describe the frequency of risk factors, patterns of management, and outcome of patients admitted with stroke in Fortaleza, the fifth largest city in Brazil. Methods-Data were prospectively collected from consecutive patients admitted to 19 hospitals in Fortaleza with a diagnosis of stroke or transient ischemic attack from June 2009 to October 2010. Results-We evaluated 2407 consecutive patients (mean age, 67.7Ϯ14.4 years; 51.8% females). Ischemic stroke was the most frequent subtype (72.9%) followed by intraparenchymal hemorrhage (15.2%), subarachnoid hemorrhage (6.0%), transient ischemic attack (3%), and undetermined stroke (2.9%). The median time from symptoms onset to hospital admission was 12.9 (3.8 -32.5) hours. Hypertension was the most common risk factor. Only 1.1% of the patients with ischemic stroke received thrombolysis. The median time from hospital admission to neuroimaging was 3.4 (1.2-26.5) hours. In-hospital mortality was 20.9% and the frequency of modified Rankin Scale score Յ2 at discharge was less than 30%. Older age, prestroke disability, and having a depressed level of consciousness at admission were independent predictors of poor outcome; conversely, male gender was a predictor of good outcome. Conclusions-The prevalence of stroke risk factors and clinical presentation in our cohort were similar to previous series.Treatment with thrombolysis and functional independency after a stroke admission were infrequent. We also found long delays in hospital admission and in evaluation with neuroimaging and high in-hospital mortality. (Stroke. 2011;42:3341-3346.)

Gender differences are well described for patients with ischemic stroke. Conversely, sex disparities in stroke presentation, risk factors, treatment, and outcomes for intracerebral hemorrhage (ICH) were not previously studied. Our objective was to compare the frequency of risk factors, management patterns, symptoms at presentation, complication rates, and outcomes between genders in patients with ICH in Fortaleza, Brazil. Methods: Data were prospectively collected from patients admitted to 19 hospitals in Fortaleza with a diagnosis of ICH by trained research coordinators from June 2009 to October 2010. Daily visits to the selected hospitals were performed, and all patients admitted with a diagnosis of ICH were prospectively evaluated. Results: We evaluated 364 patients, 47.5% of whom were women. Men were younger (59.3 ± 14.58 years vs. 66.3 ± 14.6 years, p < 0.001), more frequently smokers (33.1 vs. 16.6%, p < 0.01) and had a higher frequency of alcohol abuse (48.5 vs. 8.2%, p < 0.01) than women. Women had a trend to have more dyslipidemia (41.1 vs. 31.3%, p = 0.12). Clinical presentation was similar between genders including the presence of motor and sensory deficits, headache, and depressed level of consciousness at presentation. Men had more speech disturbances than women (63.6 vs. 52.7%, p = 0.04). The time interval from symptoms onset to hospital admission was longer in women (25.1 ± 82.4 h vs. 7.9 ± 50.3 h, p = 0.08). Complication rates including pneumonia and deep vein thrombosis were not different between genders. Mortality was similar in both sexes (females: 35.8% vs. males: 33%, p = 0.66). Men were more frequently independent at discharge when evaluated by the modified Rankin Scale (mRS) score (mRS ≤2: 19.7% in men and 8.1% in women, p < 0.01). In the multivariate logistic regression analysis, older age, pre-stroke disability, depressed consciousness at admission, and female gender were independent predictors of poor outcome at discharge. Conclusion: Overall risk factors for ICH in men and women were similar in our series. Men had a higher frequency of alcohol abuse and smoking. Women were older, had an increased time length from symptoms onset to hospital admission and had a worse prognosis at discharge. A better understanding of the gender disparities in patients with ICH will hopefully lead to better outcomes in both sexes in the future.