Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/10425 |
Resumo: | INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS), Charcot's disease, is a neurodegenerative progressive disease characterized by a selective loss of motoneurons in the spinal cord, brain stem and motor cortex and leads patient to death in 2 to 5 years. Epidemiological studies have been developed with the objective of studying the survival and the clinical and demographic characteristics of this disease. OBJECTIVE: To describe and to analyze the clinical- epidemiological profile of ALS in Goias, through the analyzed sample, stratifying them by sex, age, type of sclerosis presentation and county of origin; to evaluate the existing constraints using the International Classification of Functionality, Disability and Health, known as ICF. METHODOLOGY: This is an observational study, retrospective of the descriptive type of ALS cases treated at the Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo, from January 1st 2016 to January 1st 2018. The statistical analysis was made using the SPSS program, version 15.0 and the data were summarized in averages, medians and proportions. RESULTS: 135 patients with ALS according to El Escorial criteria were studied, being 7 patients with familial 128 with Sporadic ALS. The analyzed sample consisted of 73 (54.1%) patients from the male sex and 62 (45.9%) female, being the sex ratio (M: F), 1.18: 1. They were grouped into two with 34 (25.2%) patients classified as Bulbars and 101 (74.8%) grouped as non-Bulbars. The average age was 59 years. The average time from first symptoms to the first evaluation in the institution was 4.64 years. In the Bulbars the highest prevalence was of the female population (p 0.034). There was not a statistically significant difference in mortality between the two groups, during the two-year follow- up. The Bulbar patients have already arrived at the institution to rehabilitation with severe dysphagia (p 0.007) and gastrostomy (p 0.007) and in its large majority, with complete inability to communicate verbally (d3300: 4 with p 0.007). The Kolmogorov-Smirnov adhesion test was performed to evaluate if the distance of each county and age contributed to the abandonment of follow-up and the loss of CRER follow-up, there was no statistical difference between the two groups. The distribution of the predominant non-Bulbar and Bulbar clinical forms, presents itself similar to those reported in the literature with an average of 59 years, with a variation between 22 and 87 years old, in which the elderly population accounted for more than 53%, in the male sex (1,18: 1). The bulbar form was more frequent in females in relation to the classical form. It was observed that patients arrived at the institution with great incapacity to perform the Instrumental Activities of Daily Living (IADL), as well as with a significant percentage of disability for Daily Life Activities (ADL). Analyzing the initial function losses with the clinical classification in the studied groups, we observed the highest prevalence of aphasia (p 0.007, OR 3.22), severe dysphagia (p 0.007, OR 1.44) and consequently gastrostomized patients in the evaluation of the group whose patients were classified as Bulbars, a fact that corroborates the clinic of the referred subgroup. The survival study demonstrates variation when we analyze non-Bulbar forms and Bulbar. |
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Diniz, Denise Sisterollihttp://lattes.cnpq.br/5139602841690387Guimarães, Valeriana de Castrohttp://lattes.cnpq.br/6222102545181441Diniz, Denise SisterolliGuimarães, Valeriana de CastroMendonça, Helena Rezende Silvahttp://lattes.cnpq.br/8429328931648588Braga, Cristhiano Augusto de Oliveira Holanda2020-03-16T13:54:38Z2019-05-14BRAGA, Cristhiano Augusto de Oliveira Holanda. Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro. 2019. 95 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2019.http://repositorio.bc.ufg.br/tede/handle/tede/10425INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS), Charcot's disease, is a neurodegenerative progressive disease characterized by a selective loss of motoneurons in the spinal cord, brain stem and motor cortex and leads patient to death in 2 to 5 years. Epidemiological studies have been developed with the objective of studying the survival and the clinical and demographic characteristics of this disease. OBJECTIVE: To describe and to analyze the clinical- epidemiological profile of ALS in Goias, through the analyzed sample, stratifying them by sex, age, type of sclerosis presentation and county of origin; to evaluate the existing constraints using the International Classification of Functionality, Disability and Health, known as ICF. METHODOLOGY: This is an observational study, retrospective of the descriptive type of ALS cases treated at the Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo, from January 1st 2016 to January 1st 2018. The statistical analysis was made using the SPSS program, version 15.0 and the data were summarized in averages, medians and proportions. RESULTS: 135 patients with ALS according to El Escorial criteria were studied, being 7 patients with familial 128 with Sporadic ALS. The analyzed sample consisted of 73 (54.1%) patients from the male sex and 62 (45.9%) female, being the sex ratio (M: F), 1.18: 1. They were grouped into two with 34 (25.2%) patients classified as Bulbars and 101 (74.8%) grouped as non-Bulbars. The average age was 59 years. The average time from first symptoms to the first evaluation in the institution was 4.64 years. In the Bulbars the highest prevalence was of the female population (p 0.034). There was not a statistically significant difference in mortality between the two groups, during the two-year follow- up. The Bulbar patients have already arrived at the institution to rehabilitation with severe dysphagia (p 0.007) and gastrostomy (p 0.007) and in its large majority, with complete inability to communicate verbally (d3300: 4 with p 0.007). The Kolmogorov-Smirnov adhesion test was performed to evaluate if the distance of each county and age contributed to the abandonment of follow-up and the loss of CRER follow-up, there was no statistical difference between the two groups. The distribution of the predominant non-Bulbar and Bulbar clinical forms, presents itself similar to those reported in the literature with an average of 59 years, with a variation between 22 and 87 years old, in which the elderly population accounted for more than 53%, in the male sex (1,18: 1). The bulbar form was more frequent in females in relation to the classical form. It was observed that patients arrived at the institution with great incapacity to perform the Instrumental Activities of Daily Living (IADL), as well as with a significant percentage of disability for Daily Life Activities (ADL). Analyzing the initial function losses with the clinical classification in the studied groups, we observed the highest prevalence of aphasia (p 0.007, OR 3.22), severe dysphagia (p 0.007, OR 1.44) and consequently gastrostomized patients in the evaluation of the group whose patients were classified as Bulbars, a fact that corroborates the clinic of the referred subgroup. The survival study demonstrates variation when we analyze non-Bulbar forms and Bulbar.INTRODUÇÃO: A Esclerose Lateral Amiotrófica (ELA), doença de Charcot, é uma doença neurodegenerativa progressiva caracterizada por uma perda seletiva de neurônios motores na medula espinhal, tronco encefálico e córtex motor, levando o paciente a óbito em cerca de 2 a 5 anos. Estudos epidemiológicos vêm sendo desenvolvidos com objetivo de estudar a sobrevida e as características clínicas e demográficas desta enfermidade. OBJETIVO: Descrever e analisar o perfil clínico-epidemiológico da ELA no Estado de Goiás, através da amostra analisada, estratificando-os por sexo, idade, tipo de apresentação da esclerose e município de origem; avaliar as limitações existentes utilizando a Classificação Internacional de Funcionalidade, Incapacidade e Saúde, conhecida como CIF. METODOLOGIA: Trata-se de um estudo observacional, retrospectivo do tipo descritivo a partir de casos de ELA atendidos no Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo, de 01 de janeiro de 2016 a 01 de janeiro de 2018. A análise estatística foi realizada utilizando o programa SPSS versão 15.0 e os dados foram sumarizados em médias, medianas e proporções. RESULTADOS: Foram estudados 135 pacientes com diagnóstico de ELA definitiva, de acordo com os critérios de El Escorial, sendo 7 pacientes com ELA Familiar e 128 com ELA Esporádica. A amostra analisada foi constituída de 73 (54,1%) pacientes do sexo masculino e 62 (45,9%) do sexo feminino, sendo a razão de sexo (M:F), 1,18:1. Foram agrupados em dois grupos com 34 (25,2%) pacientes classificados como Bulbares e 101 (74,8%) agrupados como não Bulbares. A média etária foi de 59 anos. O tempo médio do início dos sintomas até a primeira avaliação na instituição foi de 4,64 anos. Nos Bulbares à maior prevalência foi da população feminina (p 0,034). Não houve diferença estatisticamente significante quanto a mortalidade entre os dois grupos, durante o seguimento dos dois anos. Os pacientes Bulbares já chegaram na instituição para reabilitação com disfagia severa (p 0,007) e gastrostomizados (p 0,007) e em sua grande maioria com incapacidade completa para comunicar- se de forma verbal (d3300:4 com p 0,007). Realizou-se o teste de aderência Kolmogorov-Smirnov para avaliar se a distância de cada município e a idade contribuíram para o abandono do acompanhamento e a perda de seguimento no CRER, não havendo diferença estatística entre os dois grupos. CONCLUSÃO: A distribuição das formas clínicas predominantes não Bulbar e Bulbar, se mostra semelhante aos relatos da literatura com uma média de 59 anos, com uma variação entre 22 a 87 anos, na qual a população idosa correspondeu a mais de 53%, predominando no sexo masculino (1,18:1). A forma bulbar foi mais frequente no sexo feminino em relação à forma clássica. Observou-se que os pacientes já chegaram na instituição com grande incapacidade para realização das Atividades Instrumentais de Vida Diária (AIVD’s), bem como com um percentil significativo de incapacidade para as Atividades de Vida Diária (AVD’s). Quando analisadas as perdas funcionais iniciais com a classificação clínica nos grupos estudados observamos a maior prevalência de afasia (p 0,007; OR 3,22), disfagia severa (p 0,007; OR 1,44) e consequentemente de pacientes gastrostomizados na avaliação no grupo cujos pacientes foram classificados com Bulbares, fato este que corrobora a clínica do subgrupo referido. O estudo da sobrevida não demonstra variação quando analisamos as formas não Bulbar e Bulbar.Submitted by Franciele Moreira (francielemoreyra@gmail.com) on 2020-03-05T14:24:16Z No. of bitstreams: 2 Dissertação - Cristhiano Augusto de Oliveira Holanda Braga - 2019.pdf: 18726380 bytes, checksum: c0e83df2b08fcf3441cf4c36b388e868 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Rejected by Luciana Ferreira (lucgeral@gmail.com), reason: Não sei se podemos publicar, pois tem artigo que foi submetido em periódico de acesso restrito, mas não consegui descobrir se foi aceito ou não. on 2020-03-06T10:32:39Z (GMT)Submitted by Franciele Moreira (francielemoreyra@gmail.com) on 2020-03-13T11:23:12Z No. of bitstreams: 2 Dissertação - Cristhiano Augusto de Oliveira Holanda Braga - 2019.pdf: 18726380 bytes, checksum: c0e83df2b08fcf3441cf4c36b388e868 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2020-03-16T13:54:37Z (GMT) No. of bitstreams: 2 Dissertação - Cristhiano Augusto de Oliveira Holanda Braga - 2019.pdf: 18726380 bytes, checksum: c0e83df2b08fcf3441cf4c36b388e868 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2020-03-16T13:54:38Z (GMT). No. of bitstreams: 2 Dissertação - Cristhiano Augusto de Oliveira Holanda Braga - 2019.pdf: 18726380 bytes, checksum: c0e83df2b08fcf3441cf4c36b388e868 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2019-05-14application/pdfporUniversidade Federal de GoiásPrograma de Pós-graduação em Ciências da Saúde (FM)UFGBrasilFaculdade de Medicina - FM (RG)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessEsclerose lateral amiotróficaEpidemiologiaFuncionalidadeAmyotrophic lateral sclerosisEpidemiologyFunctionalityCIENCIAS DA SAUDEEstudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiroEpidemiological study of patients with amyrotrophic lateral sclerosis in a rehabilitation reference hospital in the brazilian west centerinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis-100686431261774531060060060015457724759504863388765449414823306929reponame:Biblioteca Digital de Teses e Dissertações da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGLICENSElicense.txtlicense.txttext/plain; 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dc.title.eng.fl_str_mv |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
dc.title.alternative.eng.fl_str_mv |
Epidemiological study of patients with amyrotrophic lateral sclerosis in a rehabilitation reference hospital in the brazilian west center |
title |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
spellingShingle |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro Braga, Cristhiano Augusto de Oliveira Holanda Esclerose lateral amiotrófica Epidemiologia Funcionalidade Amyotrophic lateral sclerosis Epidemiology Functionality CIENCIAS DA SAUDE |
title_short |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
title_full |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
title_fullStr |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
title_full_unstemmed |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
title_sort |
Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro |
author |
Braga, Cristhiano Augusto de Oliveira Holanda |
author_facet |
Braga, Cristhiano Augusto de Oliveira Holanda |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Diniz, Denise Sisterolli |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5139602841690387 |
dc.contributor.advisor-co1.fl_str_mv |
Guimarães, Valeriana de Castro |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/6222102545181441 |
dc.contributor.referee1.fl_str_mv |
Diniz, Denise Sisterolli |
dc.contributor.referee2.fl_str_mv |
Guimarães, Valeriana de Castro |
dc.contributor.referee3.fl_str_mv |
Mendonça, Helena Rezende Silva |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8429328931648588 |
dc.contributor.author.fl_str_mv |
Braga, Cristhiano Augusto de Oliveira Holanda |
contributor_str_mv |
Diniz, Denise Sisterolli Guimarães, Valeriana de Castro Diniz, Denise Sisterolli Guimarães, Valeriana de Castro Mendonça, Helena Rezende Silva |
dc.subject.por.fl_str_mv |
Esclerose lateral amiotrófica Epidemiologia Funcionalidade |
topic |
Esclerose lateral amiotrófica Epidemiologia Funcionalidade Amyotrophic lateral sclerosis Epidemiology Functionality CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Amyotrophic lateral sclerosis Epidemiology Functionality |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS), Charcot's disease, is a neurodegenerative progressive disease characterized by a selective loss of motoneurons in the spinal cord, brain stem and motor cortex and leads patient to death in 2 to 5 years. Epidemiological studies have been developed with the objective of studying the survival and the clinical and demographic characteristics of this disease. OBJECTIVE: To describe and to analyze the clinical- epidemiological profile of ALS in Goias, through the analyzed sample, stratifying them by sex, age, type of sclerosis presentation and county of origin; to evaluate the existing constraints using the International Classification of Functionality, Disability and Health, known as ICF. METHODOLOGY: This is an observational study, retrospective of the descriptive type of ALS cases treated at the Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo, from January 1st 2016 to January 1st 2018. The statistical analysis was made using the SPSS program, version 15.0 and the data were summarized in averages, medians and proportions. RESULTS: 135 patients with ALS according to El Escorial criteria were studied, being 7 patients with familial 128 with Sporadic ALS. The analyzed sample consisted of 73 (54.1%) patients from the male sex and 62 (45.9%) female, being the sex ratio (M: F), 1.18: 1. They were grouped into two with 34 (25.2%) patients classified as Bulbars and 101 (74.8%) grouped as non-Bulbars. The average age was 59 years. The average time from first symptoms to the first evaluation in the institution was 4.64 years. In the Bulbars the highest prevalence was of the female population (p 0.034). There was not a statistically significant difference in mortality between the two groups, during the two-year follow- up. The Bulbar patients have already arrived at the institution to rehabilitation with severe dysphagia (p 0.007) and gastrostomy (p 0.007) and in its large majority, with complete inability to communicate verbally (d3300: 4 with p 0.007). The Kolmogorov-Smirnov adhesion test was performed to evaluate if the distance of each county and age contributed to the abandonment of follow-up and the loss of CRER follow-up, there was no statistical difference between the two groups. The distribution of the predominant non-Bulbar and Bulbar clinical forms, presents itself similar to those reported in the literature with an average of 59 years, with a variation between 22 and 87 years old, in which the elderly population accounted for more than 53%, in the male sex (1,18: 1). The bulbar form was more frequent in females in relation to the classical form. It was observed that patients arrived at the institution with great incapacity to perform the Instrumental Activities of Daily Living (IADL), as well as with a significant percentage of disability for Daily Life Activities (ADL). Analyzing the initial function losses with the clinical classification in the studied groups, we observed the highest prevalence of aphasia (p 0.007, OR 3.22), severe dysphagia (p 0.007, OR 1.44) and consequently gastrostomized patients in the evaluation of the group whose patients were classified as Bulbars, a fact that corroborates the clinic of the referred subgroup. The survival study demonstrates variation when we analyze non-Bulbar forms and Bulbar. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-05-14 |
dc.date.accessioned.fl_str_mv |
2020-03-16T13:54:38Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
BRAGA, Cristhiano Augusto de Oliveira Holanda. Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro. 2019. 95 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2019. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/10425 |
identifier_str_mv |
BRAGA, Cristhiano Augusto de Oliveira Holanda. Estudo epidemiológico de pacientes com esclerose lateral amiotrófica em um hospital de referência de reabilitação no centro oeste brasileiro. 2019. 95 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2019. |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/10425 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
-1006864312617745310 |
dc.relation.confidence.fl_str_mv |
600 600 600 |
dc.relation.department.fl_str_mv |
1545772475950486338 |
dc.relation.cnpq.fl_str_mv |
8765449414823306929 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Goiás |
dc.publisher.program.fl_str_mv |
Programa de Pós-graduação em Ciências da Saúde (FM) |
dc.publisher.initials.fl_str_mv |
UFG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Faculdade de Medicina - FM (RG) |
publisher.none.fl_str_mv |
Universidade Federal de Goiás |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFG instname:Universidade Federal de Goiás (UFG) instacron:UFG |
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Universidade Federal de Goiás (UFG) |
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UFG |
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UFG |
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Biblioteca Digital de Teses e Dissertações da UFG |
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Biblioteca Digital de Teses e Dissertações da UFG |
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Biblioteca Digital de Teses e Dissertações da UFG - Universidade Federal de Goiás (UFG) |
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tesesdissertacoes.bc@ufg.br ||tesesdissertacoes.bc@ufg.br |
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