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Abstract(s)
Introdução e objetivos: O acidente vascular cerebral (AVC) isquémico é uma das principais causas de mortalidade e incapacidade a nível mundial, tendo vindo a aumentar a sua prevalência nos adultos jovens. Este estudo pretende analisar as diferentes etiologias e fatores de risco desta entidade nosológica, em doentes considerados adultos jovens, no contexto de uma enfermaria de Medicina Interna.
Métodos: Estudo retrospetivo que incluiu doentes internados com o diagnóstico de AVC isquémico com idade igual ou inferior a 55 anos, num período de 4 anos (1 de janeiro de 2016 – 31 de dezembro de 2019). A classificação etiológica foi realizada de acordo com os critérios TOAST (Trial of Org 10172 In Acute Stroke Treatment). Foram também analisados fatores de risco cardiovascular. Efetuou-se uma análise estatística descritiva entre as diferentes séries da amostra.
Resultados: Foram incluídos 46 doentes com idades compreendidas entre os 23 e os 55 anos, sendo 27 do sexo masculino (59%) e 19 do sexo feminino (41%). A etiologia de AVC mais frequente foi a cardioembólica (28,3%), com a maioria destes casos a corresponderem a foramen ovale patente. “Outra etiologia” (incluindo trombofilias, neoplasias e vasculites) foi o segundo grupo mais frequente (13%). Aterosclerose de grandes artérias e oclusão de pequenos vasos foram as etiologias menos representadas (6,5% cada). Em 45,7% dos doentes, não foi possível determinar a etiologia destes acidentes cerebrovasculares. Os principais fatores de risco cardiovascular identificados foram a hipertensão arterial (67,4%), o tabagismo (41,3%), a dislipidemia (37%) e a diabetes mellitus (21,7%).
Conclusão: O reconhecimento das diferentes etiologias e fatores de risco para esta entidade é fundamental para o clínico conseguir realizar uma investigação etiológica adequada e elaborar estratégias de prevenção primária e secundária.
Background and purpose: Ischemic stroke is one of the leading causes of death and disability worldwide and its prevalence in young adults has been rising. This study intends to analyze the various etiologies and risk factors for this nosological entity in a population of young adults hospitalized in an Internal Medicine ward. Methods: Retrospective study of four years (1st of January 2016 – 31st of December 2019) that included patients hospitalized with ischemic stroke aged 55 or under. Etiology was classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. We also examined vascular risk factors. A descriptive statistical analysis was performed between the different sample series. Results: 46 patients were included, with ages ranging from 23 to 55. There were 27 males (59%) and 19 females (41%). The most frequent etiology was cardioembolism (28,3%), with most of these being due to patent foramen ovale. “Other determined etiology” (including thrombophilia, active cancer and vasculitis) was the second most frequent (13%). Large arthery atherosclerosis and small vessel disease were the least common (6,5% each). In 45,7% of the patients, it was not possible to determine the etiology. The main risk factors were hypertension (67,4%), cigarette smoking (41,3%) and diabetes mellitus (21,7%). Conclusions: Recognizing the different etiologies and risk factors for this disease is critical for the clinician to be able to conduct an adequate etiological investigation and to develop primary and secondary prevention strategies.
Background and purpose: Ischemic stroke is one of the leading causes of death and disability worldwide and its prevalence in young adults has been rising. This study intends to analyze the various etiologies and risk factors for this nosological entity in a population of young adults hospitalized in an Internal Medicine ward. Methods: Retrospective study of four years (1st of January 2016 – 31st of December 2019) that included patients hospitalized with ischemic stroke aged 55 or under. Etiology was classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. We also examined vascular risk factors. A descriptive statistical analysis was performed between the different sample series. Results: 46 patients were included, with ages ranging from 23 to 55. There were 27 males (59%) and 19 females (41%). The most frequent etiology was cardioembolism (28,3%), with most of these being due to patent foramen ovale. “Other determined etiology” (including thrombophilia, active cancer and vasculitis) was the second most frequent (13%). Large arthery atherosclerosis and small vessel disease were the least common (6,5% each). In 45,7% of the patients, it was not possible to determine the etiology. The main risk factors were hypertension (67,4%), cigarette smoking (41,3%) and diabetes mellitus (21,7%). Conclusions: Recognizing the different etiologies and risk factors for this disease is critical for the clinician to be able to conduct an adequate etiological investigation and to develop primary and secondary prevention strategies.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Keywords
AVC isquémico Etiologia Fatores de risco Adulto jovem