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Abstract(s)
Introdução: Os acidentes vasculares cerebrais (AVC) nos adultos jovens (atĂ© 65 anos) sĂŁo considerados uma patologia pouco comum e o seu diagnĂłstico etiolĂłgico constitui frequentemente um desafio clĂnico. A Diabetes Mellitus representa um fator de risco importante para o AVC nestes pacientes, no entanto nĂŁo existem muitos estudos acerca da associação entre ambos.
Este estudo teve como objetivo analisar a influĂȘncia da glicĂ©mia na evolução do AVC do doente jovem no distrito da Guarda, entre os anos de 2007 e 2011.
MĂ©todos: Neste estudo retrospetivo, analisaram-se 156 processos de AVC isquĂ©mico e hemorrĂĄgico em adultos jovens (atĂ© aos 65 anos). A anĂĄlise estatĂstica foi realizada no programa SPSS (Statistical Package for the Social Sciences) da IBM, versĂŁo 22.0.
Resultados: Foi possĂvel verificar que 75% dos casos correspondem a AVC isquĂ©mico e 25% a AVC hemorrĂĄgico. O sexo masculino foi o mais afetado (72%) e a mĂ©dia de idades do total dos pacientes foi de 55,67±8,10 anos. No que diz respeito Ă Diabetes Mellitus, 69% dos pacientes nĂŁo estavam diagnosticados com esta patologia, enquanto que 5% tinha Diabetes Mellitus tipo I e 26% tipo II. De entre todos os pacientes diabĂ©ticos os homens sĂŁo os mais afetados (71,4%). NĂŁo foi encontrada nenhuma interação significativa entre o sexo e tipo de AVC sobre os valores da glicĂ©mia Ă entrada do SU (p=0,659), e as mĂ©dias da glicĂ©mia dos sexos nĂŁo sĂŁo significativamente diferentes quer para AVCI (p=0,577) quer para AVCH (p=0,456). A associação entre a presença de diabetes e o tipo de AVC Ă© inexistente (p=0,693). No que diz respeito ao nĂșmero de dias de internamento, os pacientes com AVCH passam mais tempo internados (p<0,001) em comparação com doentes que sofreram AVCI (20,54±13,576 dias versus 12,44±11,270 respetivamente). No entanto, a presença de Diabetes Mellitus nĂŁo influencia o nĂșmero de dias de internamento (p=0,337).
DiscussĂŁo: A percentagem de casos de AVC isquĂ©mico (75%) e hemorrĂĄgico (25%) assim como a maior tendĂȘncia para a Diabetes Mellitus no sexo masculino, estĂŁo de acordo com outros estudos realizados em pacientes jovens em Portugal. Apesar de nĂŁo haver indĂcios de uma associação entre a diabetes e o tipo de AVC, Ă© importante referir que existem muitos fatores que influenciam estes resultados. No que diz respeito aos dias de internamento, nĂŁo existe diferença entre as mĂ©dias de dias de internamento nos pacientes diabĂ©ticos ou nĂŁo diabĂ©ticos que sofrerem AVCI. Esta informação nĂŁo estĂĄ de acordo com a literatura, que refere um aumento dos dias de internamento nos pacientes diabĂ©ticos que sofrerem AVCI. ConclusĂŁo: Este estudo nĂŁo revela uma associação da glicĂ©mia Ă entrada na etiologia do AVC nem na sua evolução, porĂ©m Ă© necessĂĄrio efetuar mais estudos com uma amostra maior e com registos completos da glicĂ©mia Ă entrada no SU e o correto diagnĂłstico de Diabetes Mellitus dos doentes.
Introduction: Cerebrovascular accidents (CVA), most commonly referred to as strokes, are considered an uncommon disease in young adults (age below 65 years) and its etiological diagnosis is often a clinical challenge. Diabetes Mellitus is a major risk factor for stroke in these patients; however there are very few studies that investigate the association between the two. The main objective of this study was to analyse the influence of blood glucose levels on the evolution of stroke in young patients, in the district of Guarda, between 2007 and 2011. Methods: In this retrospective study, 156 medical case reports of ischemic and hemorrhagic strokes in young adults (age below 65 years) were analysed. SPSS (Statistical Package for Social Sciences) from IBM, version 22.0 was used for the statistical analysis of the data. Results: It was possible to confirm that 75% of the medical case reports were due to ischemic strokes and 25% were due to hemorrhagic stokes. Men are more affected (72%) and the mean age of the total population was 55.67±8.10 years. With respect to Diabetes Mellitus, 69% of the patients were not diagnosed with this disease, while 5% had type I Diabetes Mellitus and 26% had type II Diabetes Mellitus. Among all diabetic patients, men are more affected (71.4%). No significant interaction was found between the sex or type of stroke and the blood glucose levels upon entry into the ER (p=0.659) and the mean blood glucose levels in both sex are not significantly different for both ischemic stroke (p=0.577) and hemorrhagic stroke (p=0.456). The association between the presence of diabetes and the type of stroke is nonexistent (p=0.693). Concerning the length of stay, patients with hemorrhagic strokes are admitted in hospital for a longer period of time (p <0.001) when compared to patients who have suffered ischemic stroke (20.54±13.576 days versus 12.44± 11.270 days respectively). However, the presence of Diabetes Mellitus does not influence the number of days of hospitalization (p=0.337). Discussion: The percentage of cases of ischemic stroke (75%) and hemorrhagic stroke (25%), as well as the greater tendency for the Diabetes Mellitus in men, are in agreement with other studies on young patients in Portugal. Although there is no evidence of an association between diabetes and the type of stroke, it is important to note that there are many factors that may influence these results. With regard to the length of stay, there is no difference between the mean number of length of stay in diabetic and non-diabetic patients who have suffered ischemic stroke. This information is not in agreement with the literature, which indicates an increase in the length of stay in diabetic patients who have suffered ischemic stroke. Conclusion: This study does not reveal an association between blood glucose levels upon entry into the ER and stroke ethology or its evolution; however, it is necessary to carry out further studies with a larger sample size and with complete medical records of blood glucose levels upon entry into the ER and correct diagnosis of Diabetes Mellitus in the patients.
Introduction: Cerebrovascular accidents (CVA), most commonly referred to as strokes, are considered an uncommon disease in young adults (age below 65 years) and its etiological diagnosis is often a clinical challenge. Diabetes Mellitus is a major risk factor for stroke in these patients; however there are very few studies that investigate the association between the two. The main objective of this study was to analyse the influence of blood glucose levels on the evolution of stroke in young patients, in the district of Guarda, between 2007 and 2011. Methods: In this retrospective study, 156 medical case reports of ischemic and hemorrhagic strokes in young adults (age below 65 years) were analysed. SPSS (Statistical Package for Social Sciences) from IBM, version 22.0 was used for the statistical analysis of the data. Results: It was possible to confirm that 75% of the medical case reports were due to ischemic strokes and 25% were due to hemorrhagic stokes. Men are more affected (72%) and the mean age of the total population was 55.67±8.10 years. With respect to Diabetes Mellitus, 69% of the patients were not diagnosed with this disease, while 5% had type I Diabetes Mellitus and 26% had type II Diabetes Mellitus. Among all diabetic patients, men are more affected (71.4%). No significant interaction was found between the sex or type of stroke and the blood glucose levels upon entry into the ER (p=0.659) and the mean blood glucose levels in both sex are not significantly different for both ischemic stroke (p=0.577) and hemorrhagic stroke (p=0.456). The association between the presence of diabetes and the type of stroke is nonexistent (p=0.693). Concerning the length of stay, patients with hemorrhagic strokes are admitted in hospital for a longer period of time (p <0.001) when compared to patients who have suffered ischemic stroke (20.54±13.576 days versus 12.44± 11.270 days respectively). However, the presence of Diabetes Mellitus does not influence the number of days of hospitalization (p=0.337). Discussion: The percentage of cases of ischemic stroke (75%) and hemorrhagic stroke (25%), as well as the greater tendency for the Diabetes Mellitus in men, are in agreement with other studies on young patients in Portugal. Although there is no evidence of an association between diabetes and the type of stroke, it is important to note that there are many factors that may influence these results. With regard to the length of stay, there is no difference between the mean number of length of stay in diabetic and non-diabetic patients who have suffered ischemic stroke. This information is not in agreement with the literature, which indicates an increase in the length of stay in diabetic patients who have suffered ischemic stroke. Conclusion: This study does not reveal an association between blood glucose levels upon entry into the ER and stroke ethology or its evolution; however, it is necessary to carry out further studies with a larger sample size and with complete medical records of blood glucose levels upon entry into the ER and correct diagnosis of Diabetes Mellitus in the patients.
Description
Keywords
Adulto Jovem Avc Diabetes Dias Internamento Glicémia Guarda