Mortality from Stroke in Pará, Brazilian Amazon: a Joinpoint Analysis

Abstract

Introduction: Stroke is a significant cause of death worldwide. Temporal studies show a downward trend in mortality rates in recent decades, with variability between countries. The State of Pará, in northern Brazil, has a low human development index and high mortality from stroke; however, little research is reported.

Objective: This study aims to analyze the trend in stroke mortality in the adult population of Pará, between 2000 and 2021.

Method: This is an ecological, time series study based on official secondary population data. Joinpoint regression models were used to identify the trend of each coefficient segment of the mortality rate and years of potential life lost.

Results: There were 49,259 deaths in this period, with an absolute increase in fatalities during the time series and an increase in the age group. The mortality coefficient showed a stationary mortality trend of 0.4% between 2000 and 2021 (p=0.576); however, after 2008, the trend decreased -1.0% (p=0.003). In the stratified analysis, a decreasing mortality trend was detected: -2.3% between 30 and 39 years old (p<0.001), -2.8% between 40 and 49 years old (p<0.001), -2.1% between 50 and 59 years old (p<0.001) and -1.4% between 60 and 69 years old (p<0.001), between the year 2000 and 2021. In the other age groups, the trend decreased -2.5% between 20 and 29 years old after 2006 (p= 0.003), -1.8% between 70 and 79 years old after 2008 (p=0.001), and -5.1% among 80 years old and over after 2016 (p=0.010).

Conclusion: The mortality trend attributed to stroke among adults in Pará State remained stable from 2000 to 2021. Despite this stability, the absolute number of deaths remained consistently high, underscoring the critical need to mitigate risk factors and enhance the care and management of affected individuals.