Relationship between risk factors, changes in cervical and transcranial triplex scan and post-stroke functional status in the elderly
DOI:
https://doi.org/10.25758/set.702Keywords:
Stroke, Risk factors, Elderly, Cervical and transcranial triplex scanAbstract
Introduction – Stroke is characterized by a sudden focal decrease in cerebral blood flow and causes physical and neurological deficits or death. Risk factors are important conditioning factors in the occurrence of stroke, leading to a decrease in the individuals’ functional status. Objectives – To relate the functional status after stroke in the elderly with the number of associated risk factors as well as the characteristics of the cervical (TSC) and transcranial (TST) duplex scans. Methods – A retrospective longitudinal observational study was carried out, consisting of a non-probabilistic convenience sample of 93 individuals aged over 65 years with a diagnosis of ischemic stroke admitted to the Neurology department of the Hospital de Vila Franca de Xira. Results – In the relationship between risk factors and the modified Rankin scale (mRS) at discharge, it was found that only in grades 1-2 of the scale there was a higher prevalence of individuals with more than three associated risk factors. In grades 0 and 4 of the scale, there was a higher prevalence of individuals with less than two associated risk factors. Comparing the relationship between cervical and cerebral alterations and mRS, it was found that in all grades of the scale, there was a higher prevalence of individuals with less than two associated alterations. Hypertension was the most important risk factor for the occurrence of stroke, being present in 84.8% of individuals. Discussion – Although no studies were found that assessed the functional status with the grouping of risk factors and changes at the cervical and cerebral level in the same way as what was done in this study, in this sample it was observed that the presence of a greater or lesser number of factors and alterations did not significantly lead to a worse functional status. Regarding arterial hypertension, this study corroborates other studies. Conclusion – We did not find a direct relationship between the number of risk factors and changes in TSC and TST present in each individual with their functional status at discharge, after the stroke. Hypertension was the most prevalent risk factor in the sample and, with regard to cervical changes, the most prevalent was the presence of atheromatous plaques.
Downloads
References
World Health Organization. Stroke, cerebrovascular accident [homepage]. Geneva: WHO; 2021 [cited 2021 May 18]. Available from: https://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html
Damata SR, Formiga LM, Araújo AK, Oliveira EA, Oliveira AK, Formiga RC. Perfil epidemiológico dos idosos acometidos por acidente vascular cerebral [Epidemiological profile of elderly afflicted with stroke]. Rev Interdisc Centro Univ Uninovafapi. 2016;9(1):107-17. Portuguese
Direção-Geral da Saúde. Programa nacional para as doenças cérebro-cardiovasculares. Lisboa: DGS; 2017.
Chung JW, Park SH, Kim N, Kim WJ, Park JH, Ko Y, et al. Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification and vascular territory of ischemic stroke lesions diagnosed by diffusion‐weighted imaging. J Am Heart Assoc. 2014;3(4):e001119.
Ferreira LR. Neuroepidemiologia no mundo: o particular de Portugal [dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar; 2011.
Lo Coco D, Lopez G, Corrao S. Cognitive impairment and stroke in elderly patients. Vasc Health Risk Manag. 2016;12:105-16.
Maineri NL, Xavier FM, Berleze MC, Moriguchi EH. Risk factors for cerebrovascular disease and cognitive function in the elderly. Arq Bras Cardiol. 2007;89(3):142-6.
Pires SL, Gagliardi RJ, Gorzoni ML. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos [Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patient]. Arq Neuropsiquiatr. 2004;62(3-B):844-51. Portuguese
Gagliardi RJ. Hipertensão arterial e AVC. ComCiência. 2009;(109).
Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120(3):472-95.
Mateus SM. Acidente vascular cerebral: fatores de risco, exames imagiológicos e repercussões económicas [dissertation]. Évora: Universidade de Évora; 2015.
National Institute of Neurological Disorders and Stroke. In: NIH Stroke Scale.
Functional Independence Measure. 2016;1–2.
Broderick JP, Adeoye O, Elm J. Evolution of the Modified Rankin Scale and its use in future stroke trials. Stroke. 2017;48(7):2007-12.
Wilson JT, Hareendran A, Grant M, Baird T, Schulz UG, Muir KW, et al. Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale. Stroke. 2002;33(9):2243-6.
Organização Mundial da Saúde. Manual STEPS de acidentes vascular cerebrais da OMS: enfoque passo a passo para a vigilância de acidentes vascular cerebrais [Internet]. Organização Pan-Americana da Saúde; 2009. Available from: https://www.paho.org/hq/dmdocuments/2009/manualpo.pdf
Silva MA. O AVC e o género : perfil do doente com AVC e eventuais diferenças e semelhanças entre os sexos [dissertation]. Covilhã: Faculdade de Ciências da Saúde, Universidade da Beira Interior; 2012.
Andersen KK, Andersen ZJ, Olsen TS. Age- and gender-specific prevalence of cardiovascular risk factors in 40,102 patients with first-ever ischemic stroke: a nationwide Danish study. Stroke. 2010;41(12):2768-74.
Freitas P, Piccinato CE, Martins WP, Mauad Filho F. Aterosclerose carotídea avaliada pelo eco-Doppler: associação com fatores de risco e doenças arteriais sistêmicas [Carotid atherosclerosis evaluated by Doppler ultrasound: association with risk factors and systemic arterial disease]. J Vasc Bras. 2009;7(4):298-307. Portuguese
Cipolla MJ, Liebeskind DS, Chan SL. The importance of comorbidities in ischemic stroke: impact of hypertension on the cerebral circulation. J Cereb Blood Flow Metab. 2018;38(12):2129-49.
Xia X, Yue W, Chao B, Li M, Cao L, Wang L, et al. Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey. J Neurol. 2019;266(6):1449-58.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Saúde e Tecnologia
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The journal Saúde & Tecnologia offers immediate free access to its content, following the principle that making scientific knowledge available to the public free of charge provides greater worldwide democratization of knowledge.
The journal Saúde & Tecnologia does not charge authors any submission or article processing charges (APC).
All content is licensed under a Creative Commons CC-BY-NC-ND license. Authors have the right to: reproduce their work in physical or digital form for personal, professional, or teaching use, but not for commercial use (including the sale of the right to access the article); deposit on their website, that of their institution or in a repository an exact copy in electronic format of the article published by Saúde & Tecnologia, provided that reference is made to its publication in Saúde & Tecnologia and its content (including symbols identifying the journal) is not altered; publish in a book of which they are authors or editors the total or partial content of the manuscript, provided that reference is made to its publication in Saúde & Tecnologia.
