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Abstract(s)
Introdução: O papel da infecção aguda como factor de risco para Acidente
Vascular Cerebral tem sido objecto de discussão há já muitos anos, e vários
são os estudos que demonstram que a infecção na semana prévia, pode
precipitar enfartes isquémicos, em todos os grupos etários, com uma
prevalência que varia de 10-35%. Os estudos já realizados atribuem às
infecções respiratórias, particularmente bacterianas, uma função de gatilho
mais preponderante.
Objectivos: Este estudo teve como objectivo investigar uma possível
associação entre um AVC e infecções recentes, até uma semana antes do
evento vascular. A par disso, procurou também encontrar alguma relação com
algum grupo etário, com o tipo e subtipo de AVC, com a presença ou não de
factores de risco cardiovasculares, e com o desenvolvimento de complicações
durante o internamento, nesses doentes com infecção prévia. Também se
tentou averiguar se existiria algum tipo de infecção mais predominantemente
associado.
Métodos: Foi realizado um estudo prospectivo durante os meses de
Novembro, Dezembro de 2009 e Janeiro de 2010, na Unidade de Acidentes
Vasculares Cerebrais do Centro Hospitalar Cova da Beira, onde se incluíram
todos os doentes com AVC/AIT, aos quais foi realizado um pequeno
questionário para averiguar a história de infecção prévia. Na impossibilidade de
estes comunicarem foi um familiar quem respondeu ao questionário. Foram também analisados os processos clínicos dos doentes através do programa
SAMS.
A análise dos resultados foi feita no programa SPSS, versão 15.
Resultados: Dos 79 doentes que preenchiam os critérios de inclusão, 69 eram
AVC’s isquémicos e 10 eram do tipo Hemorrágico. A história de infecção foi
recolhida de 36 doentes, dos quais 14 assumem ter tido infecção, 8 de causa
bacteriana e 6 de causa viral, 10 com origem no tracto respiratório e 4 no tracto
urinário. São 22 os doentes que negam a presença de infecção previamente. A
média de idades nos doentes com infecção é de 77, 21 anos. Não foram
encontradas associações significativas entre a infecção e os parâmetros
analíticos de infecção, nem com os tipos e subtipos de AVC, nem com os
factores de risco cardiovasculares, nem com a presença de complicações no
internamento, com p sempre superior a 0,05.
Conclusão: Infecções agudas não parecem ter associação significativa com o
desencadear de um AVC e mais estudos serão necessários, com novas
abordagens, para verificar o papel de gatilho da infecção, que outros estudos já
demonstraram, e quiçá encontrar aqui novas abordagens para prevenção de
um AVC.
Introduction: Acute infection’s role as a risk factor for Cerebrovascular Accidents (CVA) has been object of discussion for many years and there are several studies that demonstrate that infection in the previous week can precipitate ischemic strokes in all ages, with a prevalence that varies between 10% and 35%. Studies attribute the function of a more preponderant trigger to respiratory infections, particularly to the bacterial ones. Goals: The purpose of this study was to investigate a possible association between stroke and recent infections, up to one week before the vascular event. Moreover, it also looked to find some relation with age, with the type and subtype of stroke, with the presence or absence of cardiovascular risk factors and with the development of complications during hospital admission, in those patients with previous infection. Also, it aimed to discover a predominantly associated infection. Methods: A prospective study during the months of November and December of 2009 and January of 2010 was carried through in the Stroke Unit of Hospital Center Cova da Beira, where all the patients with CVA/TIA had been included, and a small questionnaire to these patients applied, to inquire about the history of previous infection. If communication with the patient was not possible, the family was sought to answer the questionnaire. The clinical processes of the patients where also analyzed through SAMS program. The analysis of the results was made using the SPSS program, version number 15. Results: Of the 79 patients who filled the inclusion criteria, 69 had an ischemic stroke and 10 a hemorrhagic type. The infection history was collected from 36 patients, 14 of which assumed to have had infection, 8 of bacterial cause and 6 of viral cause, 10 originating in the respiratory tract and 4 in the urinary tract. There were 22 patients that denied a previous infection. The mean age of the patients with infection was 77,21 (+/- 7,266) years. Significant associations between the infection and the analytical parameters of infection were not found, neither with the types and subtypes of stroke, nor with the cardiovascular risk factors, nor with the presence of complications in the hospital admission, with a p value always >0,05. Conclusion: Acute infections do not seem to have a significant association with the development of a stroke and more studies will be necessary, with new approaches, to verify the role of infection as a trigger, previously demonstrated by other studies, and to possibly find new approaches to prevent a stroke.
Introduction: Acute infection’s role as a risk factor for Cerebrovascular Accidents (CVA) has been object of discussion for many years and there are several studies that demonstrate that infection in the previous week can precipitate ischemic strokes in all ages, with a prevalence that varies between 10% and 35%. Studies attribute the function of a more preponderant trigger to respiratory infections, particularly to the bacterial ones. Goals: The purpose of this study was to investigate a possible association between stroke and recent infections, up to one week before the vascular event. Moreover, it also looked to find some relation with age, with the type and subtype of stroke, with the presence or absence of cardiovascular risk factors and with the development of complications during hospital admission, in those patients with previous infection. Also, it aimed to discover a predominantly associated infection. Methods: A prospective study during the months of November and December of 2009 and January of 2010 was carried through in the Stroke Unit of Hospital Center Cova da Beira, where all the patients with CVA/TIA had been included, and a small questionnaire to these patients applied, to inquire about the history of previous infection. If communication with the patient was not possible, the family was sought to answer the questionnaire. The clinical processes of the patients where also analyzed through SAMS program. The analysis of the results was made using the SPSS program, version number 15. Results: Of the 79 patients who filled the inclusion criteria, 69 had an ischemic stroke and 10 a hemorrhagic type. The infection history was collected from 36 patients, 14 of which assumed to have had infection, 8 of bacterial cause and 6 of viral cause, 10 originating in the respiratory tract and 4 in the urinary tract. There were 22 patients that denied a previous infection. The mean age of the patients with infection was 77,21 (+/- 7,266) years. Significant associations between the infection and the analytical parameters of infection were not found, neither with the types and subtypes of stroke, nor with the cardiovascular risk factors, nor with the presence of complications in the hospital admission, with a p value always >0,05. Conclusion: Acute infections do not seem to have a significant association with the development of a stroke and more studies will be necessary, with new approaches, to verify the role of infection as a trigger, previously demonstrated by other studies, and to possibly find new approaches to prevent a stroke.
Description
Keywords
Acidente vascular cerebral Acidente vascular cerebral isquémico Acidente vascular cerebral hemorrágico Acidente vascular cerebral - Factores de risco Acidente vascular cerebral - Infecção
Pedagogical Context
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Universidade da Beira Interior