Fatores epidemiol?gicos, cl?nicos e funcionais de pacientes com acidente vascular cerebral

• Main Author: Melo, Luciana Prot?sio de
• Other Authors: 60336641400
• Language: Portuguese
• Published: PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA 2017
• Subjects: CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL; AVC; Vigil?ncia em sa?de p?blica; Epidemiologia; Independ?ncia funcional; Fisioterapia
• Online Access: https://repositorio.ufrn.br/jspui/handle/123456789/22536

Submitted by Automa??o e Estat?stica ([e-mail]) on 2017-03-28T20:31:43Z No. of bitstreams: 1 LucianaProtasioDeMelo_TESE.pdf: 3341432 bytes, checksum: 30bddef9c5bdbeed79dbce1b402a8b04 (MD5) === Approved for entry into archive by Arlan Eloi Leite Silva ([e-mail]) on 2017-03-30T00:04:50Z (GMT) No. of bitstreams: 1 LucianaProtasioDeMelo_TESE.pdf: 3341432 bytes, checksum: 30bddef9c5bdbeed79dbce1b402a8b04 (MD5) === Made available in DSpace on 2017-03-30T00:04:50Z (GMT). No. of bitstreams: 1 LucianaProtasioDeMelo_TESE.pdf: 3341432 bytes, checksum: 30bddef9c5bdbeed79dbce1b402a8b04 (MD5) Previous issue date: 2016-11-29 === O Acidente Vascular Cerebral (AVC) ? um importante problema de sa?de p?blica, por isso foi realizado um estudo com o objetivo de avaliar os fatores epidemiol?gicos, cl?nicos e funcionais de pacientes com AVC. Participaram do estudo 433 pacientes (229 mulheres e 204 homens). Em Natal/RN, os pacientes foram avaliados atrav?s do Step 1 e Escala de Rankin Modificada. Os dados foram analisados pelo teste Qui-quadrado e an?lise de regress?o log?stica. Resultados: Verificou-se maior frequ?ncia de pacientes na faixa et?ria de 70 a 89 anos (40,9%). A hipertens?o arterial foi o fator de risco mais frequente (85,4%) e o AVC isqu?mico (68,5%). Foi observada maior frequ?ncia de pacientes com incapacidade de andar e realizar higiene pessoal (48,8%) (p= 0,001). Observou-se uma correla??o entre o grau de comprometimento neurol?gico e a funcionalidade (r= 0,53; p= 0,006). Considerando as atividades b?sicas da vida di?ria (ABVDs), 25% dos pacientes n?o podiam levantar da cama e 70,8% n?o conseguiam ir ao banheiro sozinhos (ambos p< 0.05). Os modelos de regress?o apontaram os fatores preditores da depend?ncia funcional para as atividades: "banho", quantidade de fatores de risco (OR=0,4; IC=0,2-0,7; p=0,005) e quantidade de medica??o usada previamente ao AVC (OR=1,7; IC=1,1-27; p=0,013). Para "higiene pessoal", realiza??o de Fisioterapia ap?s a alta (OR=2,5; IC=1,2-5,1; p=0,014) e sexo feminino (OR=1,6; IC=1,06-2,4; p=0,026); para "transfer?ncia", quantidade de fatores de risco (OR=0,4; IC=0,2-0,9; p=0,025); para "contin?ncia", tipo de AVC (OR=2,2; IC=1,1-3,8; p=0,003 ? 10? dia; OR=1,9; IC=1,1-3,3; p=0,013 ? 28? dia) e realiza??o de Fisioterapia ap?s a alta (OR=4,1; IC=1,5-11,3; p=0,005); e para atividade "alimenta??o", quantidade de AVC pr?vio (OR=0,5; IC=0,2-0,9; p=0,036) e realiza??o de Fisioterapia ap?s a alta (OR=4,2; IC=1,6-11,1; p=0,003). Para as seis atividades, a idade acima de 60 anos e a falta de realiza??o da fisioterapia durante a interna??o hospitalar foram os mais fortes fatores preditivos para a depend?ncia funcional. Os resultados indicam fatores importantes que influenciam a depend?ncia funcional dos pacientes com AVC, trazem uma contribui??o cient?fica para que os prestadores de sa?de possam identificar oportunidades de interven??o e apontam a necessidade urgente de implanta??o de Unidades de AVC no Estado Rio Grande do Norte. === 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.