{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:04:01Z","timestamp":1777943041914,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T00:00:00Z","timestamp":1475193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Year 2000 marked a turning point in stroke prevention and treatment in Portugal. In face of high incidence rates stroke awareness campaigns, close surveillance of vascular risk factors and implementation of hospital stroke units were advanced by the National Health Authorities. To understand the effect of such measures, we assessed changes in stroke incidence and short-term outcome using data from two community-based registers undertaken in Porto in 1998\u20132000 and 2009\u20132011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used standard diagnostic criteria and multiple overlapping sources of case-ascertainment for first-ever strokes. Short-term outcome was measured by the modified Rankin Scale; disabling stroke was defined whenever post-stroke mRS score&gt;pre-stroke mRS and &gt;1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Globally, 462 and 405 first-ever stroke cases were registered in 1998\u20132000 and 2009\u20132011, respectively. Stroke incidence decreased by 23%, from 261 to 203\/100,000 after adjustment for the Portuguese population. Significant reduction was found in those aged &lt;75 years (31%) and in women (32%). Incidence of disabling strokes was reduced by 29%. Fatal strokes decreased by 46%, while intracerebral hemorrhage decreased by 51%. Risk of disability from stroke decreased by 11% (RR\u2009=\u20090.89; 95%CI, 0.81\u20130.98) in 2009\u20132011, as found after adjusting for patient\/stroke characteristics in a Poisson model. Moreover, when patients arrived hospital within 3\u2009h from stroke onset, the risk of disabling stroke was 0.76 (95%CI, 0.67\u20130.87) in 2009\u20132011 vs. 1998\u20132000, compared to 1.03 (95%CI, 0.89\u20131.12) for late arrival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Risk of stroke, mainly of hemorrhagic stroke, was substantially reduced over time. Timely action in acute phase was responsible for the decline in disability across periods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493016669846","type":"journal-article","created":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T21:29:10Z","timestamp":1475270950000},"page":"169-179","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Changes in stroke incidence, outcome, and associated factors in Porto between 1998 and 2011"],"prefix":"10.1177","volume":"12","author":[{"given":"Manuel","family":"Correia","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Neurologia, Hospital Santo Ant\u00f3nio\u2013Centro Hospitalar do Porto, Porto, Portugal"},{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal"}]},{"given":"Rui","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal"}]},{"given":"Rui","family":"Felgueiras","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neurologia, Hospital Santo Ant\u00f3nio\u2013Centro Hospitalar do Porto, Porto, Portugal"}]},{"given":"Cl\u00e1udia","family":"Quintas","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neurologia, Hospital Santo Ant\u00f3nio\u2013Centro Hospitalar do Porto, Porto, Portugal"}]},{"given":"Laura","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"CIIMAR \u2013 Interdisciplinary Centre of Marine and Environmental Research, Porto, Portugal"}]},{"given":"Maria C","family":"Silva","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal"}]}],"member":"179","published-online":{"date-parts":[[2016,9,30]]},"reference":[{"key":"bibr1-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000137606.34301.13"},{"key":"bibr2-1747493016669846","unstructured":"[\n                      National Program for Prevention and Control of Cardiovascular Diseases\n                      ]. Despacho n\u00b0. 16415\/2003 (II S\u00e9rie) \u2013 Di\u00e1rio da Rep\u00fablica n\u00b0193 de 22 de Agosto. Lisboa: Minist\u00e9rio da Sa\u00fade\/Direc\u00e7\u00e3o-Geral da Sa\u00fade, 2003."},{"key":"bibr3-1747493016669846","unstructured":"[\n                      Risk of dying in Portugal\n                      , 1999]. Lisboa: Direc\u00e7\u00e3o-Geral da Sa\u00fade, 2001."},{"key":"bibr4-1747493016669846","unstructured":"[\n                      Risk of dying in Portugal\n                      , 2005]. Lisboa: Direc\u00e7\u00e3o-Geral da Sa\u00fade, 2007."},{"key":"bibr5-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61953-4"},{"key":"bibr6-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/str.35.9.2045"},{"key":"bibr7-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.3.550"},{"key":"bibr8-1747493016669846","first-page":"113","volume":"26","author":"Moutinho M","year":"2013","journal-title":"Acta Med Port"},{"key":"bibr9-1747493016669846","first-page":"113","volume":"58","author":"Aho K","year":"1980","journal-title":"Bull World Health Organ"},{"key":"bibr10-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.3.491"},{"key":"bibr11-1747493016669846","unstructured":"Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R and Inoue M. Age standardization of rates: a new WHO standard. In:\n                      GPE Discussion Paper Series: No 31\n                      , World Health Organization, 2001."},{"key":"bibr12-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"bibr13-1747493016669846","unstructured":"[\n                      Risk of dying in Portugal\n                      , 2006]. Lisboa: Direc\u00e7\u00e3o-Geral da Sa\u00fade, 2009."},{"key":"bibr14-1747493016669846","unstructured":"[\n                      Risk of dying in Portugal\n                      , 2012]. Lisboa: Instituto Nacional de Estatistica\/Direc\u00e7\u00e3o-Geral da Sa\u00fade, 2014."},{"key":"bibr15-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.542787"},{"key":"bibr16-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1016\/j.genm.2012.02.002"},{"key":"bibr17-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.542894"},{"key":"bibr18-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1159\/000102141"},{"key":"bibr19-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1159\/000328867"},{"key":"bibr20-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318270401d"},{"key":"bibr21-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005930"},{"key":"bibr22-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-306203"},{"key":"bibr23-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002604"},{"key":"bibr24-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0134609"},{"key":"bibr25-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1159\/000354851"},{"key":"bibr26-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2009.00293.x"},{"key":"bibr27-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000144683.96048.98"},{"key":"bibr28-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.10.1787"},{"key":"bibr29-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000162"},{"key":"bibr30-1747493016669846","first-page":"967","volume":"22","author":"Costa J","year":"2003","journal-title":"Rev Port Cardiol"},{"key":"bibr31-1747493016669846","first-page":"12","volume":"17","author":"Perdig\u00e3o C","year":"2010","journal-title":"Revista Factores de Risco"},{"key":"bibr32-1747493016669846","first-page":"335","volume":"22","author":"Precioso J","year":"2009","journal-title":"Acta Med Port"},{"key":"bibr33-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001564"},{"key":"bibr34-1747493016669846","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2011.04.002"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493016669846","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493016669846","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493016669846","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:14:12Z","timestamp":1777706052000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493016669846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,30]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1177\/1747493016669846"],"URL":"https:\/\/doi.org\/10.1177\/1747493016669846","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,30]]}}}