BACKGROUND: Stroke is the principal cause of disability around the world and the ensuing functional dependence (FD) can be correlated with different factors. OBJECTIVE: To determine how demographic factors and clinical characteristics after stroke distinguish patients who achieve functional independence from those who do not. DESIGN AND SETTING: Observational study at specialized neurovascular clinic in Alagoas, Brazil. METHODS: FD was classified according to the modified Rankin scale (mRs): 0 to 2 points were classified as independent (FD-), and 3 to 5 points were classified as dependent (FD+). Logistic regression analysis included age, sedentary lifestyle, the Center for Epidemiological Studies-Depression Scale (CES-D) and the National Institutes of Health Stroke Scale (NIHSS). The Mann-Whitney test and χ 2 test were used to compare groups. RESULTS: We included 190 stroke patients with a mean age of 60.02 ± 14.22 years. We found that 34.8% of the patients were classified as FD+. Lower NIHSS and CES-D scores were more associated with achieving functional independence. Most of the patients had access to physical therapy, and the mean duration of rehabilitation therapy was 65.2 minutes per week. Females had higher prevalence of depressive symptoms (P = 0.005) and rehabilitation time was shorter for hemorrhagic stroke (P = 0.02). CONCLUSION: We found a FD rate four times greater than in another Brazilian study. Lower stroke severity and fewer depressive symptoms were associated with achieving functional independence. Less than half of the patients were referred to a rehabilitation service at hospital discharge and few had access to multidisciplinary treatment.
Background There is little information available on stroke epidemiology in the northeast of Brazil. Objective Our objective was to investigate the prevalence of the stroke subtypes, prevalence of cerebrovascular risk factors and patterns of management in a public neurovascular outpatient referral service, in Alagoas. Methods Data were prospectively collected from consecutive patients with stroke who were treated in a specialized neurovascular clinic between November 2016 and June 2018. Recurrence was evaluated by telephone 12 months after patients had been included in the study. Results We evaluated 190 patients (mean age, 60.22 ( 13.29 years; 60.5% males). Ischemic stroke was the most frequent subtype (85.2%). Sedentary lifestyle was the most common risk factor (71.6%), followed by hypertension (62.6%) and stroke family history (41.1%). Only 21.5% of the patients were transported by ambulance to the hospital, and 42.6% received medical support in hospital units or emergency units with no imaging support. The median NIHSS was 2.5 (IQR, 1-5) and mRS was 2 (IQR, 1-3). We found a high rate of undetermined stroke (35.8%), and few patients completed the etiological investigation. One year after inclusion in the study, 12 patients (6.3%) had died and 14 (7.3%) had had another stroke. Conclusions The prevalence of cerebrovascular risk factors and clinical presentation were similar to what had been seen in previous series. A notable number of patients received medical support in institutions with no imaging equipment. The high number of cases of undetermined stroke etiology shows the difficulty in accessing healthcare services in Alagoas.
vs 36 (IQ 30-45). Após análise multivariada, o fator de risco independentemente associado à estenose intracraniana foi a hipertesão arterial sistêmica na admissão (p=0,006). Nos 100 pacientes com ambos os exames, a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da UTC comparada a AngioTC para detecção de estenoses intracranianas moderadas-graves foi de 60%, 73%, 73% e 60%, respectivamente. Conclusões: Encontramos alta frequência de estenose arterial intracraniana entre os pacientes com AVCI agudo e AIT na nossa população, especialmente entre indivíduos portadores de hipertensão arterial sistêmica. A UTC é uma ferramenta não-invasiva que pode ser utilizada para investigação da doença moderada-grave com acurácia moderada quando comparada a AngioTC. Palavras-chave: Acidente vascular cerebral. Estenose arterial intracraniana. Ultrassonografia Transcraniana Colorida. Angiotomografia de crânio.
Introduction: COVID-19 affects several vital organs, including the brain, and can cause neurological manifestations. Objective: To characterize the neurological manifestations of hospitalized patients with laboratory confirmation of COVID-19, between May and August, 2020. Design and setting: Observational study at Veredas Hospital and University Hospital Professor Alberto Antunes in Alagoas, Brazil. Methods: Socio-demographic data, infectious and neurological symptoms, risk factors for neurological and infectious diseases, clinical history, treatment instituted and outcome of patients were collected. Results: We included 30 patients with a mean age of 61.05 ± 18.65 years, 70% were female. The average between the onset of COVID-19 symptoms and hospital admission was 10 ± 9.7 days. Systemic arterial hypertension (66.7%) and diabetes mellitus (63.3%) were the main comorbidities. Cough, fever (60%) and dyspnea (56.7%) stood out in general symptoms. The most frequent neurological symptoms were changes in the level of consciousness (56.7%), epileptic seizures (33.3%) and motor deficits (23.3%). Ischemic stroke (40%) was the main neurological diagnosis, followed by epileptic seizures (33.3%), delirium (13.3%), encephalitis (10%), SAH (6.6%), vasculitis (6, 6%), hemorrhagic stroke, TIA, cranial neuropathy, meningitis and peripheral neuropathy (3.3% each). Regarding treatment, 100% used antibiotic therapy, 96.7% prophylactic heparin, 50% mechanical ventilation, 46.7% antiparasitic, 20% vasoactive drugs and 6.7% hydroxychloroquine. The death rate was 40%. Conclusions: Neurological manifestations by patients with COVID-19 are not uncommon, presenting in different ways, and can be potentially fatal. The main neurological symptom was changes in the level of consciousness and diagnosis, ischemic stroke.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.