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ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department

Year 2019, Volume: 9 Issue: 3, 70 - 75, 16.09.2019

Abstract


ÖZET
Amaç: Genç erişkinlerde görülen iskemik inmeler, tüm inmelerin % 10-15’ini oluşturmaktadır. Bu genç erişkinleri
hayatlarının en üretken oldukları dönemde engelli bıraktığından aynı zamanda ciddi bir sosyoekonomik yüktür.
Bu nedenle hastalığı tanıma ve önleme için altta yatan nedenleri araştırmak gerekmektedir. Çalışmamızın amacı,
genç yaşlarda görülen iskemik inmelerin neden ve sonlanımlarını güncel literatür sonuçlarıyla karşılaştırmaktır.
Gereç ve Yöntem: Çalışma retrospektif olarak, 2014-2017 yılları arasında iskemik inme tanısı almış, 18-50 yaş
arasındaki hastaları kapsamaktadır. Yaş, cinsiyet, acil servis şikayetleri, fizik muayenedeki nörolojik bulgular
ve iskemik inme için birlikte bulunan hastalıklar her hasta için kayıt altına alındı. İnme alt tiplerini belirlemek
için Trial of Org 10172 in Acute Stroke Treatment (TOAST) sınıflaması kullanıldı. Hastane sonlanımları modifiye
Rankin Skalası (mRS) ile değerlendirildi. Grupların karşılaştırmasında Pearson Ki-kare testi kullanıldı. p <0.05
olması istatistiksel olarak anlamlı kabul edildi.
Bulgular: Dahil etme kriterini karşılayan 34 (%39.1)’ü kadın, 53 (60.9)’ü erkek toplam 87 hasta çalışmaya alındı.
Hastaların yaş ortalaması 44.41 ± 6.96 (değişim aralığı; 18-50) idi. En sık görülen risk faktörleri hipertansiyon
(% 55.2) ve dislipidemi (% 52.9) idi. TOAST kriterine göre değerlendirildiğinde en sık alt tip kardiyoembolik (%
28.7) bulundu. mRS skoruna baktığımızda hastaların % 54’ünün tamamen iyileştiğini görmekteyiz.
Sonuç: Genç ve üretken popülasyonu tehdit ettiğinden, nedenlerinin tespit edilmesi ve inme gelişmeden önce
tedbir almak, hastalıkla mücadele etmenin en etkili yolu gibi görünmektedir. Irksal farklılıklar her milletin
detaylı bir araştırma yapmasını gerektirmektedir.
Anahtar Kelimeler: Acil Tıp; İnme; Genç erişkin
ABSTRACT
Objective: Ischemic stroke in young adults constitutes about 10-15% of all strokes. It is also a serious
socioeconomic burden since it leaves these young adults disabled at their most productive years. For this
reason, it is necessary to investigate underlying causes in order to identify and prevent the disease. The
purpose of our study was to compare causes and outcomes of ischemic stroke at young age with the results
available in the literature.
Methods: The study retrospectively covers patients aged 18 to 50 diagnosed with ischemic stroke between
2014 and 2017 years. Age, gender, emergency department complaints, neurological findings detected on
physical examination, and comorbid diseases which were risk factors for stroke were recorded for all patients.
Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification was used for identification of stroke
subtypes. Hospital outcomes were assessed by the modified Rankin Scale (mRS). Pearson Chi-square test was
used to compare the groups. p <0.05 was assumed for statistical significance.
Results: A total of 87 patients who satisfied inclusion criteria, 34 female (39.1%) and 53 male (60.9%), were
included in the study. Mean age of the patients was 44.41 ± 6.96 (range 18-50). The highest risk factors
were hypertension (55.2%) and dyslipidemia (52.9). When assessed according to TOAST criteria, the most
frequently detected subtype was cardioembolic (28.7%). When we looked at the mRS scores, 54% of the
patients were completely cured.
Conclusion: Since it threatens youngs and productive population, identification of etiologies and taking
precautions before stroke development is the most effective way to fight the disease. Racial differences
require every nation to conduct a detailed research.
Keywords: Emergency Medicine; Stroke; Young adult

References

  • 1. Singhal AB, Biller J, Elkind MS, Fullerton HJ, Jauch EC, Kittner SJ, et al. Recognition and management of stroke in young adults and adolescents. Neurology. 2013;81:1089-97. 2. Hart R, Sherman D, Miller V, Easton JD. Diagnosis and management of ischemic stroke: Selected controversies. Curr Probl Cardiol. 1983;8:43-53. 3. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Register: Analysis of 1000 consecutive patients with first stroke. Stroke. 1988;19:1083-92. 4. Dharmasaroja P. Baseline characteristics of patients with acute ischemic stroke in a suburban area of Thailand. J Stroke Cerebrovasc Dis. 2008;17:82-5. 5. Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke. 2009; 40:1195-203. 6. Ferro JM, Massaro AR, Mas JL. Aetiological diagnosis of ischaemic stroke in young adults. Lancet Neurol. 2010;9:1085-96. 7. Lee TH, Hsu WC, Chen CJ, Chen ST. Etiologic study of young ischemic stroke in Taiwan. Stroke. 2002;33:1950-5. 8. Baptista MV, Ferreira S, Pinho-E-Melo T, Carvalho M, Cruz VT, Carmona C, et al. Mutations of the GLA gene in young patients with stroke: the PORTYSTROKE study-screening genetic conditions in portuguese young stroke patients. Stroke. 2010; 41:431-6. 9. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al; American Heart Association; American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009; 40:2276-93. 10. Marini C, Russo T, Felzani G. Incidence of stroke in young adults: a review. Stroke. Res Treat. 2011;2011:535672.
Year 2019, Volume: 9 Issue: 3, 70 - 75, 16.09.2019

Abstract

References

  • 1. Singhal AB, Biller J, Elkind MS, Fullerton HJ, Jauch EC, Kittner SJ, et al. Recognition and management of stroke in young adults and adolescents. Neurology. 2013;81:1089-97. 2. Hart R, Sherman D, Miller V, Easton JD. Diagnosis and management of ischemic stroke: Selected controversies. Curr Probl Cardiol. 1983;8:43-53. 3. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Register: Analysis of 1000 consecutive patients with first stroke. Stroke. 1988;19:1083-92. 4. Dharmasaroja P. Baseline characteristics of patients with acute ischemic stroke in a suburban area of Thailand. J Stroke Cerebrovasc Dis. 2008;17:82-5. 5. Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke. 2009; 40:1195-203. 6. Ferro JM, Massaro AR, Mas JL. Aetiological diagnosis of ischaemic stroke in young adults. Lancet Neurol. 2010;9:1085-96. 7. Lee TH, Hsu WC, Chen CJ, Chen ST. Etiologic study of young ischemic stroke in Taiwan. Stroke. 2002;33:1950-5. 8. Baptista MV, Ferreira S, Pinho-E-Melo T, Carvalho M, Cruz VT, Carmona C, et al. Mutations of the GLA gene in young patients with stroke: the PORTYSTROKE study-screening genetic conditions in portuguese young stroke patients. Stroke. 2010; 41:431-6. 9. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al; American Heart Association; American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009; 40:2276-93. 10. Marini C, Russo T, Felzani G. Incidence of stroke in young adults: a review. Stroke. Res Treat. 2011;2011:535672.
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Details

Primary Language Turkish
Journal Section Original Research
Authors

Özcan Yavaşi

Ömer Lütfi Gündoğdu This is me

Publication Date September 16, 2019
Published in Issue Year 2019 Volume: 9 Issue: 3

Cite

APA Yavaşi, Ö., & Gündoğdu, Ö. L. (2019). ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department. Bozok Tıp Dergisi, 9(3), 70-75.
AMA Yavaşi Ö, Gündoğdu ÖL. ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department. Bozok Tıp Dergisi. September 2019;9(3):70-75.
Chicago Yavaşi, Özcan, and Ömer Lütfi Gündoğdu. “ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department”. Bozok Tıp Dergisi 9, no. 3 (September 2019): 70-75.
EndNote Yavaşi Ö, Gündoğdu ÖL (September 1, 2019) ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department. Bozok Tıp Dergisi 9 3 70–75.
IEEE Ö. Yavaşi and Ö. L. Gündoğdu, “ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department”, Bozok Tıp Dergisi, vol. 9, no. 3, pp. 70–75, 2019.
ISNAD Yavaşi, Özcan - Gündoğdu, Ömer Lütfi. “ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department”. Bozok Tıp Dergisi 9/3 (September 2019), 70-75.
JAMA Yavaşi Ö, Gündoğdu ÖL. ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department. Bozok Tıp Dergisi. 2019;9:70–75.
MLA Yavaşi, Özcan and Ömer Lütfi Gündoğdu. “ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department”. Bozok Tıp Dergisi, vol. 9, no. 3, 2019, pp. 70-75.
Vancouver Yavaşi Ö, Gündoğdu ÖL. ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ Clinical Evaluation of Young Adult Patients With Ischemic Stroke Applying To Emergency Department. Bozok Tıp Dergisi. 2019;9(3):70-5.
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