Fatores associados ao Acidente Vascular Cerebral isquêmico em crianças e adolescentes com Tetralogia de Fallot

Abstract

The general objective was to verify the factors associated with stroke in children and adolescents with tetralogy of Fallot in an outpatient clinic specialized in pediatric cardiology and cardiovascular surgery in Northeast Brazil and outlined three specific objectives: 1st: Estimate the prevalence of T4F in children and adolescents with congenital heart disease; 2nd: Estimate the prevalence of stroke in children and adolescents with T4F and 3rd: Characterize children and adolescents with T4F and the complications found in relation to clinical and demographic variables. This is a quantitative, cross-sectional, descriptive study, carried out in an outpatient clinic specialized in pediatric cardiology and cardiovascular surgery in Northeast Brazil. It included a sample represented by all children and adolescents aged zero to 19 years with a diagnosis of tetralogy of Fallot monitored in this specialized outpatient clinic. The data were obtained through the consultation of electronic medical records, and guided by an own elaboration form. Initially, a univariate descriptive analysis of the clinical and demographic variables of children and adolescents with T4F was performed: absolute and relative frequencies for categorical variables; median and interquartile range for numerical variables. In the second stage, a bivariate analysis was performed, which consisted of verifying the factors associated with ischemic stroke in children and adolescents with T4F and Pearson's Chi-square and Fisher's exact tests were applied. All variables worked on in the bivariate analysis were included in the multivariate model of logistic regression. Those that remained in the final model were those that proved to be significant (p < 0.05). The results were described in two manuscripts that contemplated the objectives. Manuscript 1: Answered the three specific objectives of the dissertation. Of the 104 (15.5%) of the children and adolescents treated at this clinic, they have the diagnosis of tetralogy of Fallot, the majority were male (59.6%) and aged between 10 and 19 years (49%). Complications such as: ischemic stroke (6.7%), endocarditis (2.9%) and heart failure (1.9%) were evidenced. Manuscript 2: Directly answered the general objective of the dissertation. Presence of clinical factors, such as thrombophilia and polycythemia and, as a complication, cardiorespiratory arrest are independent predictors for ischemic stroke in children and adolescents with T4F. There was a high prevalence of T4F and complications resulting from this heart disease. Thus, it is essential that health professionals and services are prepared to care for these children and adolescents and, above all, public policies aimed at the children and adolescents with congenital heart disease urgently implemented, in order to promote the improvement of care and access to health care. diagnosis and treatment.