Characterization and functionality of individuals treated at a Stroke Unit in the Santa Catarina North Plateau (Brazil)
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.199928Keywords:
Epidemiology, Stroke, Health centers, Functional status, Health educationAbstract
Introduction: Known as the most disabling chronic disease, stroke affects not only the individual, but also their family and society. The percentage of individuals who remain with functional disabilities varies according to access to health services, quality of care, and secondary prevention. Among the treatment approaches, the Stroke Units (U-Stroke) enable advances in prognosis, with an 18% reduction in mortality, 25% in institutionalization, and 29% in functional dependence. Objective: To characterize post-ischemic stroke patients hospitalized in U-stroke in tmRSs of epidemiological, clinical, and functional profile. Methods: Sociodemographic data, etiology, stroke severity, and functionality were collected using the following tests, respectively: Acute Stroke Treatment National Institute of Health Stroke Scale (NIHSS); Functional Independence Measure (FIM); Modified Rankin Scale, in the hospital, 30- and 60-days post-stroke by telephone contact. Results: Of the 73 patients identified, 44 participated in the study, 79.5% of whom were over 61 years of age; 56.8% were men, 88.6% were white, 84% had incomplete primary schooling, 77% had an income of up to one minimum wage, and 79.5% attended the health center. Clinically, 96% had modifiable risk factors. Infarctions of cardioembolic origin in addition to indetmRSinate infarctions were the main etiologies (68%). The proportion with mild stroke was the minority (5%), but only 9% were eligible for thrombolytic therapy. Reasons for missing the therapeutic window: failure to identify the stroke by family members (34%); delay in the transfer of municipalities to U-CVA (18%); The two added together corresponded to an increase of 12%. In the total FIM, 54% were fully dependent, 39% moderately dependent, and 7% independent. As for the part of the motor FIM: 70% full dependents, 23% moderate dependents and 7% independent. Regarding the evolution of functionality, at discharge, 82% were dependent, i.e., with severe disability; 30 days, 57% were already walking independently, and seven individuals died; 60 days, 27% were insignificant; 29% were moderately disabled; 23% were severely disabled and one died. Conclusion: The presence of modifiable risk factors and significant loss of the therapeutic window were highlighted, possibly due to the delay in the identification of the stroke, and even the transfer of these to the U-stroke. Positively, an improvement in functional status was observed over time in the population under the care of the U-stroke. The findings allow us to elucidate the characteristics of post-stroke individuals and raise problems that can be implemented by public health education and regional health policies.
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Copyright (c) 2024 Adriélle da Costa, Chelin Auswaldt Steclan, Oscar Reimann Junior, Daniele Peres, Jonathan Wei Ting Wen Liu, Leonardo Trindade Buffara, Michael Ricardo Lang
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