| Sažetak | CILJ: Cilj istraživanja je utvrditi zastupljenost novootkrivenih nevalvularnih fibrilacija u
bolesnika s moždanim udarom, utvrditi distribuciju bolesnika prema dobi i spolu. Utvrditi udio
bolesnika koji su unatoč provedenoj tromboprofilaksi dobili moždani udar te analizirati propisanu
antikoagulacijsku terapiju pri prijemu i pri otpustu pacijenta.
ISPITANICI I METODE: Istraživanje analizira ukupno 140 pacijenata zaprimljenih na Kliniku
za neurologiju Kliničkog bolničkog centra Rijeka u razdoblju od 1.1.2023. do 31.2023.godine s
dijagnozom moždanog udara i fibrilacije atrija. Podatci prikupljeni analizom medicinske
dokumentacije uključuju dob i spol ispitanika, ima li pacijenta otprije dijagnosticiranu fibrilaciju
atrija i ako ima uzima li propisanu terapiju, također bilježimo prisustvo čimbenika rizika;
hipertenzija, diabetes mellitus, hiperlipidemija, prethodni MU/TIA, karotidnih stenoza te podatke
o tromboprofilaksi pri prijemu i pri otpustu pacijenta.
REZULTATI: Od 140 zaprimljenih pacijenata 54.3% su žene, a 45.7% muškarci, medijan dobi
iznosi 83 godine. Novootkrivena nevalvularna atrijska fibrilacija dijagnosticirana je u 42 (30%)
pacijenata, 80 (57%) pacijenta s fibrilacijom atrija unatoč antikoagulatornoj terapiji zadobivaju
moždani udar, 18 (12.9%) pacijenta unatoč poznatoj fibrilaciji nije uzimalo tromboprofilaksu.
98.6% moždanih udara ishemijskog je tipa, a kod 2 (1.4%) pacijenata javlja se hemoragijski tip
moždanog udara. Najzastupljeniji čimbenik rizika s 117 (83.6%) bolesnika je hipertenzija, a na
drugom mjestu u 38 bolesnika (27.1%) je šećerna bolest. Pri prijemu najzastupljeniji NOAK je bio
rivaroksabon koji je uzimalo 23 bolesnika (26.1%), dok pri otpustu najčešće prepisan NOAK bio
je edoksaban uveden kod 42 (35%) bolesnika.
ZAKLJUČAK: Istraživanje pokazuje zabrinjavajuću činjenicu gdje 30% ispitanika zaprimljenih
zbog moždanog udara imalo istodobno novootkrivenu nevalvularnu fibrilaciju atrija Unatoč
antikoagulantnoj terapiji 57% bolesnika doživjelo je moždani udar. Taj podatak ukazuje na
potrebu za boljom edukacijom kako medicinskog osoblja tako i samih pacijenta. Ključ uspješne
tromboprofilakse je suradnja pacijenta u vidu pravilnog uzimanja propisane terapije. Također
istraživanje ukazuje na visoku zastupljenost rizičnih čimbenika među kojima se posebno ističe
hipertenzija. |
| Sažetak (engleski) | AIM: The aim of the research is to determine the prevalence of newly discovered non-valvular
fibrillation in patients with stroke, to determine the distribution of patients according to age and
gender. To determine the proportion of patients who had a stroke despite thromboprophylaxis. we
also analyze the prescribed anticoagulation therapy at admission and at discharge of the patient.
PARTICIPANTS AND METHODS: The research analyzes a total of 140 patients admitted to
the Neurology Clinic of the Rijeka Clinical Hospital Center in the period from 1 January 2023.
until 31.2023 with a diagnosis of stroke and atrial fibrillation. The data collected through the
analysis of medical records include the age and gender of the subject, whether the patient has
previously been diagnosed with atrial fibrillation and, if so, whether he is taking the prescribed
therapy, we also record the presence of risk factors; hypertension, diabetes mellitus,
hyperlipidemia, previous stroke/TIA, stenosis, and data on thromboprophylaxis at admission and
discharge of the patient.
RESULTS: Of the 140 admitted patients, 54.3% were women and 45.7% were men, median age
was 83 years. Newly discovered nonvalvular atrial fibrillation was diagnosed in 42 (30%) patients,
80 (57%) patients with atrial fibrillation suffered a stroke despite anticoagulant therapy, 18
(12.9%) patients did not take thromboprophylaxis despite known fibrillation. 98.6% of strokes are
of the ischemic type, and 2 (1.4%) patients have a hemorrhagic type of stroke. The most frequently
described risk factor with 117 (83.6%) patients is hypertension, and in second place with 38
(27.1%) patients is diabetes mellitus. At admission, the most common anticoagulant prescribed
was rivaroxaban, which was prescribed in 23 (26.1%) patients, while at discharge, the most
frequently prescribed anticoagulant drug was edoxaban introduced in 42 (35%) patients.
CONCLUSION: The research shows a worrying fact where 30% of subjects admitted for stroke
have newly discovered non-valvular atrial fibrillation. Despite anticoagulation therapy, 57% of the
subjects had a stroke. This data points to the need for better education of both the medical staff
and the patients themselves. The key to successful thromboprophylaxis is the patient's cooperation
in the form of taking the prescribed therapy correctly. The research also indicates a high prevalence
of risk factors, among which hypertension stands out. |
