Síguenos en Twitter     Síguenos en Facebook     Síguenos en YouTube     Siguenos en Linkedin     Correo Salutsantjoan     Gmail     Dropbox     Instagram     Google Drive     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon


My photo
FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, April 26, 2012

Tromboembolismo venoso


Anderson F., 6 Spencer F. Circulation 2003; 107: I-9 - I-16
"Factors sufficient by themselves to prompt physicians to consider VTE prophylaxis include major surgery, multiple trauma, hip fracture, or lower extremity paralysis because of spinal cord injury. Additional risk factors, such as previous VTE, increasing age, cardiac or respiratory failure, prolonged immobility, presence of central venous lines, estrogens, and a wide variety of inherited and acquired hematological conditions contribute to an increased risk for VTE. These predisposing factors are seldom sufficient by themselves to justify the use of prophylaxis. Nevertheless, individual risk factors, or combinations thereof, can have important implications for the type and duration of appropriate prophylaxis and should be carefully reviewed to assess the overall risk of VTE in each patient."
Table 2
Strong risk factors (odds ratio 10): Fracture (hip or leg) - Hip or knee replacement - Major general surgery- Major trauma - Spinal cord injury
Moderate risk factors (odds ratio 2–9): Arthroscopic knee surgery - Central venous lines - Chemotherapy - Congestive heart or respiratory failure - Hormone replacement therapy - Malignancy - Oral contraceptive therapy - Paralytic stroke - Pregnancy/, postpartum - Previous venous thromboembolism - Thrombophilia
Weak risk factors (odds ratio 2): Bed rest 3 days - Immobility due to sitting (e.g. prolonged car or air travel) - Increasing age - Laparoscopic surgery (e.g. cholecystectomy) - Obesity - Pregnancy/, antepartum - Varicose veins
Low-Molecular-Weight Heparin and Mortality in Acutely Ill Medical Patients
Kakkar A., Cimminiello C., Goldhaber S., Parakh R., Wang C., Bergmann F.,
for the LIFENOX Investigators. N Engl J Med 2011; 365:2463-2472
Conclusions: The use of enoxaparin plus elastic stockings with graduated compression, as compared with elastic stockings with graduated compression alone, was not associated with a reduction in the rate of death from any cause among hospitalized, acutely ill medical patients. (Funded by Sanofi; LIFENOX ClinicalTrials.gov number, NCT00622648)