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Authors
Abstract(s)
Introdução: A Esclerose Múltipla é uma doença autoimune e primária do Sistema
Nervoso Central, sendo um dos distúrbios neurológicos mais incapacitantes e comuns nos
adultos jovens. Este estudo propõe-se a caracterizar sociodemográfica e clinicamente um
conjunto de doentes seguidos em consulta no Centro Hospitalar Universitário Cova da
Beira, assim como a avaliar possíveis diferenças entre os géneros e analisar correlações
entre informações clínicas relevantes e relacionadas com o decurso da doença.
Materiais e Métodos: Estudo transversal retrospetivo que englobou os doentes com
diagnóstico definitivo de Esclerose Múltipla seguidos em consulta de doenças
desmielinizantes com pelo menos uma consulta entre 2018 e 2019. Da amostra
selecionada de 94 doentes foram analisadas múltiplas variáveis destacando: idade, género,
fatores de risco, formas evolutivas, idade à data do diagnóstico, sintomas clínicos iniciais,
análise quantitativa e qualitativa da escala Expanded Disability Status Scale da última
consulta, número de outras comorbilidades, outras comorbilidades, número de surtos
após o início de terapêutica modificadora da doença, tratamento atual e tratamentos
prévios, entre outras. Os cálculos foram efetuados com recurso ao SPSS, versão 25,
utilizando-se a estatística descritiva para caracterização da amostra, testes paramétricos e
não paramétricos para a comparação entre grupos, e na análise de correlação os testes de
Spearman e Pearson.
Resultados: Este estudo teve uma maior proporção de mulheres (68,1%), 77,6% dos
doentes apresentaram Esclerose Múltipla Surto-Remissão, 14,89% Esclerose Múltipla
Secundária Progressiva, 4,26% Esclerose Múltipla Primária Progressiva e 3,19% Esclerose
Múltipla Progressiva com surtos, com média de idades no diagnóstico de 36,23 anos. Os
homens apresentaram maiores hábitos tabágicos (p <0,001), enquanto as mulheres
apresentaram maior número de comorbilidades (p=0,019), de Perturbação
Depressiva/Ansiedade (p=0,033) e de surtos após início de tratamento (p=0,037). Em
relação à sintomatologia inicial registaram-se diferenças entre géneros (p=0,039).
Verificou-se uma correlação positiva e estatisticamente significativa entre a duração da
doença e o número de tratamentos anteriores (p=0,036), o valor quantitativo da escala de
incapacidade (p <0,001) e o número de surtos após iniciar tratamento (p <0,o01).
Conclusão: As características sociodemográficas e clínicas desta amostra são
semelhantes à maioria dos estudos nacionais e internacionais, à exceção do registado nos
sintomas iniciais, na frequência de algumas formas evolutivas e na expressividade de
determinadas complicações secundárias e comorbilidades. Concluiu-se que existem diferenças entre géneros nalgumas características clínicas e que a duração da doença está
relacionada com um maior número de surtos, maior grau de incapacidade e maior número
de tratamentos realizados.
Introduction: Multiple Sclerosis is an autoimmune and primary disease of the Central Nervous System and is one of the most disabling neurological disorders common in young adults. This study aims to characterize sociodemographic and clinically a set of patients followed in outpatient clinic at the Centro Hospitalar Universitário Cova da Beira, as well as to evaluate possible differences between genders and analyze correlations between relevant clinical information and related to the course of the disease. Materials and Methods: Cross-sectional retrospective study that included patients with definitive diagnosis of Multiple Sclerosis followed in outpatient clinic with demyelinating diseases with at least one outpatient clinic between 2018 and 2019. From the selected sample of 94 patients, multiple variables were analyzed, highlighting: age, gender, risk factors, evolutionary forms, age at diagnosis date, initial clinical symptoms, quantitative and qualitative analysis of the Expanded Disability Status Scale of the last visit, number of other comorbidities, other comorbidities, number of relapses after the onset of disease modifying therapy, current treatment and previous treatments, among others. Calculations were performed using SPSS, version 25, using descriptive statistics for sample characterization, parametric and nonparametric tests for comparison between groups, and correlation analysis with the Spearman and Pearson tests. Results: This study had a higher proportion of women (68.1%), 77.6% of patients presented with Relapsing-remitting multiple sclerosis, 14.89% Progressive secondary multiple sclerosis, 4.26% Progressive primary multiple sclerosis and 3.19% Progressive multiple sclerosis with relapses, with a mean age at diagnosis of 36.23 years. Men presented higher smoking habits (p <0.001), while women presented higher comorbidities (p=0.019), Depression/Anxiety disorder (p=0.033) and relapses after initiation of treatment (p=0.037). In relation to the initial symptomatology there were differences between genders (p=0.039). There was a positive and statistically significant correlation between the duration of the disease and the number of previous treatments (p=0.036), the quantitative value of the disability scale (p <0.001), and the number of relapses after starting treatment (p <0.o01). Conclusion: The sociodemographic and clinical characteristics of this sample are similar to most national and international studies, with the exception of the initial symptoms, the frequency of some evolutionary forms and the expressiveness of certain secondary complications and comorbidities. It was concluded that there are gender differences in some clinical characteristics and that the duration of the disease is related to a higher number of outbreaks, a higher degree of disability and a higher number of treatments performed.
Introduction: Multiple Sclerosis is an autoimmune and primary disease of the Central Nervous System and is one of the most disabling neurological disorders common in young adults. This study aims to characterize sociodemographic and clinically a set of patients followed in outpatient clinic at the Centro Hospitalar Universitário Cova da Beira, as well as to evaluate possible differences between genders and analyze correlations between relevant clinical information and related to the course of the disease. Materials and Methods: Cross-sectional retrospective study that included patients with definitive diagnosis of Multiple Sclerosis followed in outpatient clinic with demyelinating diseases with at least one outpatient clinic between 2018 and 2019. From the selected sample of 94 patients, multiple variables were analyzed, highlighting: age, gender, risk factors, evolutionary forms, age at diagnosis date, initial clinical symptoms, quantitative and qualitative analysis of the Expanded Disability Status Scale of the last visit, number of other comorbidities, other comorbidities, number of relapses after the onset of disease modifying therapy, current treatment and previous treatments, among others. Calculations were performed using SPSS, version 25, using descriptive statistics for sample characterization, parametric and nonparametric tests for comparison between groups, and correlation analysis with the Spearman and Pearson tests. Results: This study had a higher proportion of women (68.1%), 77.6% of patients presented with Relapsing-remitting multiple sclerosis, 14.89% Progressive secondary multiple sclerosis, 4.26% Progressive primary multiple sclerosis and 3.19% Progressive multiple sclerosis with relapses, with a mean age at diagnosis of 36.23 years. Men presented higher smoking habits (p <0.001), while women presented higher comorbidities (p=0.019), Depression/Anxiety disorder (p=0.033) and relapses after initiation of treatment (p=0.037). In relation to the initial symptomatology there were differences between genders (p=0.039). There was a positive and statistically significant correlation between the duration of the disease and the number of previous treatments (p=0.036), the quantitative value of the disability scale (p <0.001), and the number of relapses after starting treatment (p <0.o01). Conclusion: The sociodemographic and clinical characteristics of this sample are similar to most national and international studies, with the exception of the initial symptoms, the frequency of some evolutionary forms and the expressiveness of certain secondary complications and comorbidities. It was concluded that there are gender differences in some clinical characteristics and that the duration of the disease is related to a higher number of outbreaks, a higher degree of disability and a higher number of treatments performed.
Description
Keywords
Clínica Comorbilidades Epidemiologia Esclerose Múltipla Fatores de Risco. Incapacidade Terapêutica