{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:50:10Z","timestamp":1791366610174,"version":"4.3.1"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"09","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stroke is the main public health problem in Brazil.<\/jats:p>\n                  <jats:p>To evaluate the incidence of moderate-to-severe disability in patients admitted to the Stroke Unit in Roraima (2024), and estimate the impact of Stroke Unit implementation on neurological outcomes compared with historical data.<\/jats:p>\n                  <jats:p>This hospital-based observational cohort study assessed factors associated with moderate-to-severe disability in patients admitted to the Stroke Unit. Clinical and sociodemographic data were collected using a semistructured questionnaire. Participants were evaluated daily until discharge or death using the National Institutes of Health stroke scale (NIHSS).<\/jats:p>\n                  <jats:p>A total of 400 patients was included. Mean age was 64.2\u2009\u00b1\u200915.8 years, and 52% of patients were male. Most cases were of ischemic stroke (82.2%), followed by wake-up stroke (13%), transient ischemic attack (TIA: 10%), and hemorrhagic stroke (1%). Systemic arterial hypertension (SAH: 57.1%), and diabetes (33.1%) were the most frequent comorbidities. Nearly 80% of patients were discharged, and the mortality rate was 3.7%. According to the modified Rankin Scale (mRS), moderate-to-severe disability at day 90 was associated with age\u2009&gt;\u200970 years (RR\u2009=\u20091.45; 95% CI\u2009=\u20091.02\u20134.53), previous stroke (RR\u2009=\u20091.35; 95% CI\u2009=\u20091.12\u20133.42), and structural heart disease (RR\u2009=\u20091.80; 95% CI\u2009=\u20091.23\u20133.28). Thrombolytic therapy was performed in 12.5% of cases and reduced moderate-to-severe sequelae by 50%.<\/jats:p>\n                  <jats:p>Stroke Unit implementation represented a significant advance in stroke care in Roraima, reducing sequelae severity and mortality, including among older patients. However, access to thrombolytic therapy remains limited due to delayed hospital admission.<\/jats:p>","DOI":"10.1055\/s-0046-1827210","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:14:07Z","timestamp":1788218047000},"page":"001-010","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic factors related to neurological disability after the implementation of the first stroke unit in a remote region of Brazil"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4674-9180","authenticated-orcid":false,"given":"Ana Rosa Ribeiro","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz\/Fiocruz, Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina Tropical, Rio de Janeiro RJ, Brazil."},{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-5469","authenticated-orcid":false,"given":"Allex Jardim da","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0319-3836","authenticated-orcid":false,"given":"L\u00edvia Maria da Silva","family":"Martins","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6229-9670","authenticated-orcid":false,"given":"Caio Cayres de","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9979-2105","authenticated-orcid":false,"given":"Joab Ferreira de","family":"Oliveira J\u00fanior","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0399-8761","authenticated-orcid":false,"given":"Ananda de Melo","family":"Albuquerque","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1428-4502","authenticated-orcid":false,"given":"Kelven Henrique Silva de","family":"Sousa","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9961-7256","authenticated-orcid":false,"given":"Raquel Gaio de","family":"Matos","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3415-2204","authenticated-orcid":false,"given":"Gustavo Proc\u00f3pio","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6130-5066","authenticated-orcid":false,"given":"Ruan Lucas de Almeida","family":"Mangueira","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima, Centro de Ci\u00eancias da Sa\u00fade, Departamento de Medicina, Boa Vista RO, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2208-0294","authenticated-orcid":false,"given":"Andr\u00e9 Machado de","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz\/Fiocruz, Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina Tropical, Rio de Janeiro RJ, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/j.1747-4949.2009.00240.x","article-title":"Stroke 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