Riesgo de tromboembolismo venoso y uso adecuado de terapia tromboprofiláctica.

  • Hugo Enrique Miranda Maldonado Hospital de Especialidades Carlos Andrade Marin
  • Andrés Orquera Carranco HOSPITAL DE ESPECIALIDADES CARLOS ANDRADE MARÍN
  • Priscila Viviana Ortiz Quiroz HOSPITAL GENERAL IBARRA IESS
  • Migleth Elizabeth Izquierdo Ludeña HOSPITAL DE ESPECIALIDADES CARLOS ANDRADE MARÍN
  • Daniela Raquel Benalcázar Vivanco HOSPITAL DE ESPECIALIDADES CARLOS ANDRADE MARÍN
  • Oswaldo Andre Bonilla Ruales HOSPITAL DE ESPECIALIDADES CARLOS ANDRADE MARÍN
  • Javier Andrés Bonilla Viteri HOSPITAL DE ESPECIALIDADES CARLOS ANDRADE MARÍN
Palabras clave: Tromboembolia Venosa/complicaciones, Trombosis de la Vena/mortalidad, Tromboembolia/tratamiento farmacológico, Enfermedades Vasculares/prevención & control, Vena, Heparina/uso terapéutico

Resumen

INTRODUCCIÓN. El tromboembolismo venoso es una complicación prevenible en pacientes hospitalizados y la estratificación del riesgo mejora la seguridad del paciente, su valoración evita su ocurrencia. OBJETIVO. Evaluar el riesgo de tromboembolismo venoso y uso adecuado de terapia tromboprofiláctica en pacientes hospitalizados. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 412 y muestra de 373 pacientes encuestados, distribuidos: 186 en Unidades Clínicas, 163 en Unidades Quirúrgicas y 24 en Obstetricia del Hospital de Especialidades Carlos Andrade Marín, desde el 21 al 23 de febrero del 2019. La tabulación y análisis de datos se realizó en el programa estadístico International Business Machines Statistical Package for the Social Sciences, versión 21. RESULTADOS. Se categorizó como alto riesgo de tromboembolismo venoso al 76,67% (286; 373) de pacientes; 49,46% (144; 163) postquirúrgicos y 69,40% (129; 286) clínicos de alto riesgo de tromboembolismo venoso, recibiendo tromboprofilaxis farmacológica
de forma adecuada el 38,80% (56; 144) de quirúrgicos y 57,40% (74; 129) de clínicos. CONCLUSIÓN. Se determinó que el uso de tromboprofilaxis no farmacológica y farmacológica con heparina de bajo peso molecular en pacientes hospitalizados con riesgo de tromboembolismo venoso, fue bajo.

Descargas

La descarga de datos todavía no está disponible.

Citas

Cohen AT, Tapson VF, Bergmann J-F, Goldhaber SZ, Kakkar AK, Deslandes B, et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. The Lancet [Internet]. 2008 Feb 2;371(9610):387–94. DOI: 10.1016/S0140-6736(08)60202-0. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60202-0/abstract.

Boonyawat K, Crowther M. Venous Thromboembolism Prophylaxis in Critically Ill Pat--ients. Seminars in thrombosis and hemostasis [Internet]. 2015 Jan 16;41(01): 068-074. Available from: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0034-1398386

Martínez-Zubieta R. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE II study): Mexican results of a national cross-sectional study. Cirugía y Cirujanos [Internet]. 2010;78(4):333–41. Available from: https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=25070

Schünemann HJ, Cushman M, Burnett AE, Kahn SR, Beyer-Westendorf J, Spencer FA, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv [Internet]. 2018. 27;2(22):3198–225. Available from: https://ashpublications.org/bloodadvances/article-lookup/doi/10.1182/bloodadvances.2018022954

Sajid MS, Desai M, Morris RW, Hamilton G. Knee length versus thigh length graduated compression stockings for prevention of deep vein thrombosis in postoperative surgical patients. Cochrane Database Syst Rev [Internet]. 2012 May 16;(5):CD007162. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007162.pub2/abstract

Luna O, Stephanía A. Comparación de tromboprofilaxis en pacientes clínicos y quirúrgicos hospitalizados en el Hospital de Especialidades Eugenio Espejo en el período septiembre-octubre 2014. Pontificia Universidad Católica del Ecuador [Internet]. 2015. URI: http://repositorio.puce.edu.ec/handle/22000/7686. Disponible en: http://repositorio.puce.edu.ec/handle/22000/7686

González Valdiviezo BL, Palacios Coello LF. Uso de medidas profilácticas acorde a clasificación de riesgo de trombo embolismo venoso y morbilidad de trombosis venosa profunda en los servicios clínicos y quirúrgicos del Hospital Enrique Garcés Quito durante mayo a julio 2015. Pontificia Universidad Católica del Ecuador [Internet]. 2015; URI: http://repositorio.puce.edu.ec/handle/22000/10419. Disponible en: http://repositorio.puce.edu.ec/handle/22000/10419

Roberts LN, Durkin M, Arya R. Annotation: Developing a national programme for VTE prevention. British Journal of Haematology [Internet]. 2017 178(1):162–70. DOI: https://doi.org/10.1111/bjh.14769. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/bjh.14769

Amin AN, Lin J, Yang G, Stemkowski S. Are There Any Differences in the Clinical and Economic Outcomes Between US Cancer Patients Receiving Appropriate or Inappropriate Venous Thromboembolism Prophylaxis? J Oncol Pract [Internet]. 2009 Jul;5(4):159-64. Available from: https://ascopubs.org/doi/full/10.1200/JOP.0942002?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed

Palareti G, Poli D. The prevention of venous thromboembolism recurrence in the elderly: a still open issue. Expert Rev Hematol [Internet]. 2018 Nov;11(11):903-909. DOI: https://doi.org/10.1080/17474086.2018.1526667. Available from: https://www.tandfonline.com/doi/full/10.1080/17474086.2018.1526667

Tapson VF, Decousus H, Pini M, Chong BH, Froehlich JB, Monreal M, et al. Venous Thromboembolism Prophylaxis in Acutely Ill Hospitalized Medical Patients: Findings From the International Medical Prevention Registry on Venous Thromboembolism. Chest [Internet]. 2007 Sep 1; 132(3):936–45. DOI: https://doi.org/10.1378/chest.06-2993. Available from: http://www.sciencedirect.com/science/article/pii/S0012369215366617

Kahn S, Panju A, Geerts W, Pineo G, Desjardins L, Turpie A, et al. Multicenter evaluation of the use of venous thromboembolism prophylaxis in acutely ill medical patients in Canada. Thrombosis research[Internet]. 2007 Dec 31;119:145–55. DOI: https://doi.org/10.1016/j.thromres.2006.01.011. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(06)00039-9

Baglin T, Barrowcliffe TW, Cohen A, Greaves M. Guidelines on the use and monitoring of heparin. British Journal of Haematology [Internet]. 2006; 133(1):19–34. Available from:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2141.2005.05953.x

Recommendations | Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism | Guidance | NICE [Internet]. Available from: https://www.nice.org.uk/guidance/ng89/chapter/Recommendations

Akinbobuyi O, Shalders L, Nokes T. Ensuring timely thromboprophylaxis on a Medical Assessment Unit. BMJ Open Quality [Internet]. 2016 Nov 1;5(1). Available from: https://bmjopenquality.bmj.com/content/5/1/u212414.w4934

Nassif Kerbauy M, de Moraes FY, Kerbauy LN, Oliveira Conterno L de, El-Fakhouri S. Venous thromboprophylaxis in medical patients: an application review. Revista da Associação Médica Brasileira (English Edition) [Internet]. 2013 Jan 1;59(3):258–64. Available from: http://www.sciencedirect.com/science/article/pii/S2255482313704661

Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral Anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST [Internet]. 2012 Feb 1;141(2):e24S-e43S. DOI: https://doi.org/10.1378/chest.11-2291 Available from: https://journal.chestnet.org/article/S0012-3692(12)60118-4/abstract

Chan K, Thadhani R, Maddux F. No difference in bleeding risk between subcutaneous enoxaparin and heparin for thromboprophylaxis in end-stage renal disease. Kidney international [Internet]. 2013 May 15;84. DOI: https://doi.org/10.1038/ki.2013.152. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)55990-5

Pai M, Adhikari NKJ, Ostermann M, Heels-Ansdell D, Douketis JD, Skrobik Y, et al. Low-molecular-weight heparin venous thromboprophylaxis in critically ill patients with renal dysfunction: A subgroup analysis of the PROTECT trial. PLOS ONE [Internet]. 2018 Jun 1;13(6):e0198285. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198285

Karaoui LR, Tawil S, Salameh P, Chamoun N. Enoxaparin 20 mg for thromboprophylaxis in severe renal impairment. J Int Med Res [Internet]. 2019 Jan 1; 47(1):225–34. DOI: https://doi.org/10.1177/0300060518799896. Available from: https://journals.sagepub.com/doi/10.1177/0300060518799896

Anderson DR, Morgano GP, Bennett C, Dentali F, Francis CW, Garcia DA, et al. American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients. Blood Adv [Internet]. 2019 Dec 10;3(23):3898–944. Available from: https://ashpublications.org/bloodadvances/article/3/23/3898/429211/American-Society-of-Hematology-2019-guidelines-for

Islam MS, editor. Thrombosis and Embolism: from Research to Clinical Practice: Volume 1 [Internet]. Springer International Publishing; 2017. (Advances in Internal Medicine). Available from: https://www.springer.com/gp/book/9783319221076

Publicado
2021-09-29
Cómo citar
1.
Miranda Maldonado H, Orquera Carranco A, Ortiz Quiroz P, Izquierdo Ludeña M, Benalcázar Vivanco D, Bonilla Ruales O, Bonilla Viteri J. Riesgo de tromboembolismo venoso y uso adecuado de terapia tromboprofiláctica. CAMbios-HECAM [Internet]. 29sep.2021 [citado 9sep.2024];20(1):26-2. Available from: https://revistahcam.iess.gob.ec/index.php/cambios/article/view/508
Sección
Estudio Original: Estudios Observacionales