Medidas antropométricas, índice de massa corporal, qualidade do sono e comorbidades como fatores de risco para o desenvolvimento do acidente vascular cerebral isquêmico

Abstract

Stroke is currently a major cause of death and disability in Brazil and worldwide. It occurs when blood flow is interrupted (ischemic stroke) or when a blood vessel ruptures (hemorrhagic stroke). The main risk factors for stroke are hypertension, diabetes, dyslipidemias, sedentary lifestyle, alcoholism, smoking, stress, and old age. Considering this, the present study evaluated the association among anthropometric measurements, body mass index (BMI), sleep quality, and comorbidities in individuals diagnosed with stroke. This was a quantitative cross-sectional study conducted in a reference hospital for stroke care in Alagoas. The study included inpatients diagnosed with ischemic stroke who were over 18 years of age, with onset of symptoms within 4.5 hours of presentation, without commitment of comprehension (aphasia). Anthropometric measurements (subscapular fold, arm, abdominal, and calf circumferences), formulas were used for bedridden patients to estimate weight and height using a tape measure, anthropometric ruler and adipometer. Neurological and functional evaluations (NIH stroke scale, National Institute of Health, and the modified Rankin Scale), and sleep quality (Pittsburgh Sleep Quality Index) were assessed in these patients. The results showed that the group most affected by stroke was composed of males, patients older than 59 years of age, those who were hypertensive (86%) and diabetics (43%). The anthropometric data showed that 40 (66%) of 60 patients had high BMI and 52 (86%) had poor sleep quality or signs of sleep disorders. The anthropometric variable subscapular skinfold showed positive correlations with stroke and the functional NIS and modified Rankin scales for the total sample population as well as sex-specific correlations (p<0,05). Higher subscapular skinfold measurements, in women, were indicative of worse post-stroke functional outcomes. A moderate correlation between sleep quality and BMI was found among the women (p<0,05), which was not significant among the men. It is concluded that the anthropometric measurements and BMI showed a strong correlation for both evaluating the nutritional status, poor sleep quality before the stroke reinforces the relationship between sleep as a pre-illness factor, after the period of hospital treatment the patients presented significant neurological and functional improvements. Moreover, the knowledge of these factors is part of the application of measures to be taken as a method of prevention and improvement of the stroke prognosis.