Análise clínica-epidemiológica dos pacientes com acidente vascular encefálico isquêmico sob as diretrizes de atendimento no Hospital e Pronto Socorro Municipal Mário Pinotti

Abstract

Cerebrovascular Accident (CVA), also popularly known as "stroke", can be classified as ischemic CVA (iCVA) or hemorrhagic CVA (hCVA). An ischemic stroke is the rapidly evolving neurological deficit caused by a focal brain injury resulting from reduced arterial blood flow (ischemia), followed by infarction, impairing the adequate supply of oxygen and nutrients to the brain tissue. On a global scale, stroke is the second leading cause of death, and, in Brazil, the fourth, with ischemic stroke being the most frequent subtype. Thus, the rapid recognition of symptoms and factors that influence prognosis are extremely important in preventing irreversible brain damage. This study aims to carry out a clinical-epidemiological analysis of patients with suspected or confirmed diagnosis of stroke at the Hospital Pronto Socorro Municipal Mário Pinotti, a reference in urgencies and emergencies in Belém-PA and compare with the goals established by the Brazilian Society of Cerebrovascular Diseases on Treatment of Ischemic Stroke. Data from medical records from the Rede Bem Estar program from July 2018 to December 2021 were used. The data were represented in Microsoft Excel tables and analyzed by the Biostat 5.5 program. Results: Men were more affected by stroke (54.3%), the age group with the highest prevalence was 61 to 80 years (52.7%). Most patients came from Belém and the metropolitan area (74.9%), followed by the interior of the state (24.6%) and from outside the state (0.5%). The time of medical care after admission was up to 2 hours in 77% of the cases and 15.9% were seen within 2 to 5 hours of time after arriving at the hospital. As for the imaging exam, about 16.2% of the sample took more than 30 minutes and 5.4% did not. The main risk factors seen were SAH (84.3%), DM (43.2%) and history of previous stroke (22.4%). Most patients had hemiparesis or hemiplegia (77.8%), language alterations (66.2%), alterations in the level of consciousness (52.4%) and labial rhyme deviation (27.3%). The therapeutic mainstay of stroke in HPSM was based on symptomatic, antiplatelet agents and statin. It was concluded that a series of factors are interconnected to achieve the best times of care, diagnosis and therapy, resulting in benefits for neurofunctionality in patients with ischemic stroke. Thus, meeting the goals recommended by national and international guidelines is essential to increasingly seek excellence in care.