[Detection of vascular risk factors and unknown atrial fibrillation in patients hospitalised in the stroke unit]. / Deteccion de factores de riesgo vascular y fibrilacion auricular no conocida en pacientes ingresados en la unidad de ictus.

INTRODUCTION: Certain modifiable cerebrovascular risk factors, such as arterial hypertension, diabetes mellitus, dyslipidaemia and atrial fibrillation, must be recognised and controlled if a decrease in the appearance of cerebrovascular diseases is to be achieved. On some occasions the presenting symptom of these risk factors may be a stroke. PATIENTS AND METHODS: A prospective observation-based study was conducted with a sample of patients who were admitted to the stroke unit of our hospital due to an acute cerebrovascular disease, namely transient ischaemic attack and ischaemic stroke, in order to determine the percentage of patients with previously undiagnosed arterial hypertension, diabetes mellitus, dyslipidaemia and atrial fibrillation. RESULTS: A total of 186 patients were selected for the study. Of the total number of patients, 24 presented unknown arterial hypertension (12.9%); 11 had unknown diabetes mellitus (5.9%); 49 had unknown hypercholesterolemia (26.3%); 15 had unknown hypertriglyceridemia (8.1%); and 22 had unknown atrial fibrillation (11.8%). Altogether 96 of them (51.6%) had at least one of these cerebrovascular risk factors. The existence of a previously undiagnosed risk factor was higher in the rural setting, in subjects who had not died at six months and in transient ischaemic attacks than in cases of ischaemic strokes. CONCLUSIONS: Over half the subjects who suffer a cerebrovascular event have a risk factor that has not previously been diagnosed. Campaigns should be carried out to implement detection of these factors, and increased efforts must be made to lower the appearance and recurrence of vascular pathologies.

TITLE: Deteccion de factores de riesgo vascular y fibrilacion auricular no conocida en pacientes ingresados en la unidad de ictus.Introduccion. Existe una serie de factores de riesgo cerebrovascular modificables, como son la hipertension arterial, la diabetes mellitus, dislipidemias y la fibrilacion auricular, cuyo reconocimiento y control es fundamental para disminuir la aparicion de enfermedades cerebrovasculares. En ocasiones, el ictus puede ser el sintoma de presentacion de estos factores de riesgo. Pacientes y metodos. Estudio observacional prospectivo de los pacientes que ingresan en la unidad de ictus de nuestro hospital por enfermedad cerebrovascular aguda ­accidente isquemico transitorio e ictus isquemico­ para conocer el porcentaje de pacientes con hipertension arterial, diabetes mellitus, dislipidemias y fibrilacion auricular no diagnosticadas previamente. Resultados. Se selecciono a 186 pacientes, de los que 24 presentaban hipertension arterial no conocida (12,9%); 11, diabetes mellitus no conocida (5,9%); 49, hipercolesterolemia no conocida (26,3%); 15, hipertrigliceridemia no conocida (8,1%), y 22 tenian fibrilacion auricular no conocida (11,8%). En total, 96 pacientes (51,6%) tenian alguno de estos factores de riesgo cerebrovascular. La existencia de un factor de riesgo no diagnosticado previamente era mayor en el medio rural, en los sujetos que no habian fallecido a los seis meses y en los ataques isquemicos transitorios respecto a los ictus isquemicos. Conclusiones. Mas de la mitad de los sujetos que sufren un evento cerebrovascular tienen un factor de riesgo que no se ha diagnosticado previamente. Se deben realizar campanas para implementar la deteccion de estos factores, asi como incidir en el control de estos para disminuir la aparicion y recidiva de patologia vascular.

[Evaluation of the instrumental activities of daily living following a stroke by means of the Lawton and Brody scale]. / Valoración de las actividades instrumentales de la vida diaria tras un ictus mediante la escala de Lawton y Brody.

INTRODUCTION: The instrumental activities of daily living are activities that are somewhat more complex than basic activities of daily living, and being able to perform them allows a person to be independent within a community. They include housework, tasks involving mobility, managing the home and property; catching the bus; cooking meals and going shopping, among other things. AIMS: To evaluate these activities using the Lawton and Brody scale following an ischaemic stroke or intraparenchymatous haemorrhage and to analyse the factors that have an influence on the functional status at six months. PATIENTS AND METHODS: We conducted a prospective study of patients admitted to the stroke unit between September 2010 and June 2011 diagnosed with ischaemic strokes and spontaneous intraparenchymatous haemorrhages. A series of clinical and demographic variables were collected. In the follow-up visit at six months, the patients were re-evaluated by measuring their score on the Lawton and Brody scale again. RESULTS: The percentages of the Lawton and Brody scale at six months were as follows: 28.9% of patients were highly dependent, 45.4% were moderately dependent and 25.6% were dependent. There were differences according to age, severity and the type of stroke, and also depending on the presence of aphasia or hemiparesis. CONCLUSIONS: Patients who have suffered an ischaemic stroke or haemorrhage present a poorer score in instrumental activities of daily living when age is more advanced, the stroke is more severe and when aphasia or hemiparesis are present.

Valoración de las actividades instrumentales de la vida diaria tras un ictus mediante la escala de Lawton y Brody / Evaluation of the instrumental activities of daily living following a stroke by means of the Lawton and Brody scale

Introducción. Las actividades instrumentales de la vida diaria son actividades más complejas que las actividades básicas de la vida diaria, y su realización permite que una persona pueda ser independiente dentro de una comunidad. Incluyen tareas domésticas, de movilidad, de administración del hogar y de la propiedad; coger el autobús; preparar la comida y realizar compras, entre otras. Objetivos. Valorar estas actividades mediante la escala de Lawton y Brody tras un ictus isquémico o hemorragia intraparenquimatosa y analizar los factores que influyen en el estado funcional a los seis meses. Pacientes y métodos. Estudio prospectivo de los pacientes ingresados en la unidad de ictus entre septiembre de 2010 y junio de 2011 con el diagnóstico de ictus isquémico y hemorragias intraparenquimatosas espontáneas. Se recogió una serie de variables clínicas y demográficas. En la visita de control a los seis meses se reevaluó a los pacientes midiendo nuevamente la escala de Lawton y Brody. Resultados. Los porcentajes de la escala de Lawton y Brody a los seis meses fueron los siguientes: un 28,9% de los pacientes con gran dependencia, un 45,4% con dependencia moderada y un 25,6% con independencia. Existen diferencias en función de la edad, la gravedad y el tipo de ictus, así como en función de la presencia de afasia o hemiparesia. Conclusiones. Los pacientes con ictus isquémico o hemorrágico presentan peor puntuación en las actividades instrumentales de la vida diaria en función de la edad avanzada, la gravedad del ictus y la presencia de afasia o hemiparesia (AU)

Introduction. The instrumental activities of daily living are activities that are somewhat more complex than basic activities of daily living, and being able to perform them allows a person to be independent within a community. They include housework, tasks involving mobility, managing the home and property; catching the bus; cooking meals and going shopping, among other things. Aims. To evaluate these activities using the Lawton and Brody scale following an ischaemic stroke or intraparenchymatous haemorrhage and to analyse the factors that have an influence on the functional status at six months. Patients and methods. We conducted a prospective study of patients admitted to the stroke unit between September 2010 and June 2011 diagnosed with ischaemic strokes and spontaneous intraparenchymatous haemorrhages. A series of clinical and demographic variables were collected. In the follow-up visit at six months, the patients were re-evaluated by measuring their score on the Lawton and Brody scale again. Results. The percentages of the Lawton and Brody scale at six months were as follows: 28.9% of patients were highly dependent, 45.4% were moderately dependent and 25.6% were dependent. There were differences according to age, severity and the type of stroke, and also depending on the presence of aphasia or hemiparesis.Conclusions. Patients who have suffered an ischaemic stroke or haemorrhage present a poorer score in instrumental activities of daily living when age is more advanced, the stroke is more severe and when aphasia or hemiparesis are present (AU)