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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(05): 315-320
DOI: 10.1590/0004-282X20190045
Article

Embolic stroke of undetermined source (ESUS) cohort of Brazilian patients in a university hospital

Coorte brasileira de pacientes com AVC embólico de fonte indeterminada (ESUS) em um hospital universitário
Gabriel Pinheiro Modolo 
1   Neurology, Psychiatry and Psycology Department, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Juli Thomaz De Souza 
1   Neurology, Psychiatry and Psycology Department, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Fernanda Cristina Winckler 
1   Neurology, Psychiatry and Psycology Department, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Natalia Cristina Ferreira 
2   Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Marcos Cristiano Lange 
3   Neurology Division, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba PR, Brazil
,
Wagner Mauad Avelar 
4   Department of Neurology, University of Campinas, Campinas, SP, Brazil
,
Marcos Ferreira Minicucci 
5   Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Carlos Clayton Macedo de Freitas 
1   Neurology, Psychiatry and Psycology Department, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Paula Schmidt Azevedo 
5   Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Gustavo José Luvizutto 
6   Department of Applied Physical Therapy, Federal University of Tri^angulo Mineiro (UFTM), Uberaba, Brazil
,
Leonardo Antçnio Mamede Zornoff 
5   Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Silméia Garcia Zanati Bazan 
5   Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
,
Rodrigo Bazan 
1   Neurology, Psychiatry and Psycology Department, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
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ABSTRACT

Embolic stroke of undetermined source (ESUS) is an important group of cryptogenic strokes that are in evidence due recent ongoing trials. We reviewed medical records at discharge from the stroke unit of all patients who met ESUS criteria and attended our institution between February 2016 and July 2017. Among 550 stroke patients, 51 had ESUS. We found that hypertension (60%), diabetes mellitus (34%), and smoking (36%) were the most prevalent risk factors. The mean National Institutes of Health Stroke Scale (NIHSS) scores were 7 at admission and 4 at discharge, while median scores on the modified Rankin scale were 0 and 2 at admission and discharge, respectively. Our sample had similar ages, risk factors prevalence and NIHSS scores at admission and discharge when compared with European and North American cohorts. Although a small cohort, our study suggests that the ESUS population is similar in countries with different health financing.

RESUMO

Acidentes vasculares cerebrais (AVC) embólicos de fonte indeterminada (ESUS) é um grupo importante de pacientes com AVC criptogênico que estão em evidência devido a recentes ensaios clínicos. Foram revisados os prontuários médicos na alta da unidade de AVC de todos os pacientes que preencheram os critérios para ESUS atendidos em nossa instituição entre fevereiro de 2016 e julho de 2017. Entre 550 AVCs, 51 eram pacientes com ESUS. Hipertensão (60%), diabetes mellitus (34%) e tabagismo (36%) foram os fatores de risco mais prevalentes. Os escores médios do National Institutes of Health Stroke Scale (NIHSS) foram 7 na admissão e 4 na alta, enquanto os escores médios na escala de Rankin modificada (mRs) foram 0 e 2 na admissão e alta, respectivamente. Nossa amostra teve idade, prevalência de fatores de risco, escores NIHSS na admissão e alta, quando comparados com coortes europeias e norte-americanas semelhantes. Apesar de ser uma pequena coorte, nosso estudo sugere que a população ESUS é semelhante em países com diferentes níveis de financiamento em saúde.

Keywords:

Stroke - embolism, embolic stroke of undetermined source

Palavras-chave:

Acidente vascular cerebral - embolia, acidentes vasculares cerebrais embólicos de fonte indeterminada


Publication History

Received: 11 May 2018

Accepted: 20 January 2019

Article published online:
16 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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