Fatores epidemiológicos, clínicos e funcionais de pacientes com acidente vascular cerebral

Abstract

Stroke is an important public health problem, thus one study was carried out with the aim to evaluate epidemiological, clinical and functional factors of stroke patients. Materials and Methods: Four hundred thirty-three patients participated in the study (229 women and 204 men). In Natal/RN, the patients were assessed through the Step 1 and the Modified Rankin Scale. The data were analysed through the chi-squared test and logistic regression analysis. Results: It was noticed that the higher frequency of patients were in the age range of 70 to 89 years (40,9%). Arterial hypertension was the most frequent risk factor (85,4%) as well as the ischemic stroke (68,5%). There was a higher frequency of patients with incapacity to walk and do their personal hygiene (48,8%) (p= 0,001). It was also observed a correlation between the degree of neurological impairment and functionality (r= 0,53; p= 0,006). Regarding the basic activities of daily living (BADL), 25% of the patients could not rise from bed and 70,8% could not go to bathroom on their own (both p< 0.05). The regression models pointed out to the predictive factors of functional dependence to the activities: “bathing”, quantity of risk factors (OR=0,4; IC=0,2-0,7; p=0,005) and quantity of medication used prior to stroke (OR=1,7; IC=1,1-27; p=0,013). To “personal hygiene”, attendance to physiotherapy after discharge (OR=2,5; IC=1,2-5,1; p=0,014) and female sex (OR=1,6; IC=1,06-2,4; p=0,026); to “transfer”, quantity of risk factors (OR=0,4; IC=0,2-0,9; p=0,025); to “continence”, type of stroke (OR=2,2; IC=1,1-3,8; p=0,003 – day 10; OR=1,9; IC=1,1- 3,3; p=0,013 – day 28) and attendance to physiotherapy after discharge (OR=4,1; IC=1,5-11,3; p=0,005); and to the activity “eating”, frequency of stroke (OR=0,5; IC=0,2-0,9; p=0,036) and attendance to physiotherapy after discharge (OR=4,2; IC=1,6- 11,1; p=0,003). To the six activities, age above 60 years and nonattendance to physiotherapy during hospital stay were the strongest predictive factors for functional dependence. Conclusion: The results indicate important factors that affect the functional dependence of stroke patients, thus bringing about a scientific contribution so that the healthcare providers may identify opportunities of intervention; they also point out the urgent need of implanting a Stroke Unit in the state of Rio Grande do Norte.