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Título

THE RELATION BETWEEN THE SEVERITY OF THE NEUROLOGICAL DEFICIENCY AND THE FUNCTIONAL DEPENDENCY DEGREE IN PATIENTS DURING THE ACUTE PHASE OF A STROKE

Resumo

Introduction: The ischemic stroke is the second most cause of people with some sort of physical impairment. The severity of the initial neurological deficiency is a relevant predictor of a post-stroke functional prognosis. Goal: To analyse the correlation between the neurological deficiency and the functional dependency in victims of a stroke during the periods of: admission to the hospital, hospital discharge and 3 months post hospital discharge. Method: longitudinal study done in the XI Gerência Regional de Saúde de Pernambuco between September/2021 and April/2022. The instruments of reasearch were the National Institutes of Health Stroke Scale (NIHSS), which was used on admission (T0) and hospital discharge (T1); and the Barthel Modified index, which was used on hospital discharge (T1) and 3 months after hospital discharge (T2). Results: 43 patients participated, most of them had a ischemic stroke (88%), men (53%), age between 51-80 (63%) and blacks (72%). Medical record of hypertension (86%), sedentary lifestyle (88%) and a non-regulated diet (65%). The median of the NIHSS T0 was 13 [4-22.5]. It shows a moderate neurological deficiency. The median of the NIHSS T1 was 6 [1-18], which shows a light neurological deficiency. There was a significant statistic difference (p=0.001) between the scores of the NIHSS T0 and T1. The evaluation of the functionality showed a severe level of dependency with a median of 20 [10;5-43] on Bathel (T1) to the detriment of the severity of the neurological deficiency reduction. After three months at home, there was a slight Barthel (T2) reduction to 17 [0-43.5], however, the severe dependency level didn’t change. We could also see a significant correlation between the NIHSS scores (T0) and Barthel’s(T1) (ρ = -0.77; p < 0.001); and between NIHSS (T0) and Barthel (T2) (ρ = -0.65; p < 0.001). Plus, there was a significant correlation (ρ = 0.79; p < 0.001) between the scores of Barthel T1 and T2. Conclusion: More severe levels of neurological deficiency verified by the NIHSS during the acute phase of a stroke grant a worse expectation of a functional prognosis in a three month period. Therefore, the relevance of therapeutic interventions directed towards the reduction of the severity of the neurological condition and the intensification of hospital rehabilitation should be reiterated.

Palavras Chave

Acute Stroke, Functional Dependency, Stroke Rehabilitation