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

Yıl 2019, Cilt: 9 Sayı: 3, 70 - 75, 16.09.2019

Özcan Yavaşi , Ömer Lütfi Gündoğdu

Öz

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

Anahtar Kelimeler

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

Kaynakça

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