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Revista Médica La Paz

versión On-line ISSN 1726-8958

Resumen

VIRUEZ SOTO, José Luis; VERA CARRASCO, Oscar  y  TORREZ CRUZ, Karen M.. ENFERMEDAD TROMBOEMBÓLICA VENOSA: ¿UNA PATOLOGÍA FRECUENTE POCO RECONOCIDA?VENOUS THROMBOEMBOLIC DISEASE: A COMMON UNDER RECOGNIZED CONDITION?. Rev. Méd. La Paz [online]. 2011, vol.17, n.2, pp. 13-20. ISSN 1726-8958.

Pulmonary embolism (PE) is the result of obstruction of the arterial circulation from pulmonary embolus, in most cases (95%), the deep venous system of the lower extremities (large proximal veins) in less frequent the pelvis. Other sources include: vena cava, righ heart, left ventricle (necrosis) and upper limbs. Emboli are rare tumors composed of, air, fibrin, amniotic fluid, bone marrow and foreign bodies. OBJETIVE The aim of this study was to determine the frequency and incidence of venous thrombosis (DVT), objectively diagnosed in the service of Medicine I, University Hospital and Intensive Care Unit, National Institute of Thorax, the city of La Paz-Bolivia. MATERIAL AND METHODS They joined the investigation all patients over 16 who were discharged or died in the service of Medicine I, University Hospital and the Intensive Care Unit, National Institute of chest for a period of 24 months between the 1 June 2004 to June 30, 2006, and had discharge diagnoses as service venous thromboembolism (VTE), pulmonary embolism (PE), acute lung and/or deep vein thrombosis (DVT). These diagnoses ofVTE, according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10), corresponding to: pulmonary embolism with acute pulmonary and cored (I-26), phlebitis and thrombophlebitis (I-80) and trhomboembophlebitis of other deep vessels of lower limbs (I-82). RESULTS The diagnosis of VTE was confirmed objectively in 22% ofthese patients, the male/ female ratio was V2. The frequency of VTE for the study period was 0.92%. The 9 patients with the diagnosis of VTE were divided into two group according to time of onset of symptoms. 5 patients (57.22%) had sings and/or symptoms of DVT or pulmonary embolism when admitted to hospitals or developed during the first four days of hospitalization, and 4 patients (42.77%) presented after the fifth day of hospitalization. The 30.98% ofpatient who developed VTE prophylaxis hospital ASA had indicated during hospitalization, although it is not possible to ensure that it had been performed correctly. One patient (6.62%) with VTE, boarding, development of illness in the course of anticoagulant treatment. Six patient (68.07%) had DVT and 2 (18.67%) TEP. In one patient (12%) confirmed the simultaneous presence of PE and DVT. Overall hospital mortality of patient with VTE attributed to other causes, was 19% (2 patients). Patients admitted to hospital with a diagnosis of VTE had a significantly lower mortality than the group that developed the disease during hospitalization (0.5% vs 30.98% respectively, ) p=0.004. Those patient by severity of symptoms (n=2) had to be hospitalized in intensive care units had a mortality rate of 43.74%. the incidenceof VTE was 0.15%, 95% IC, 0.37 to 0.42 and reached its highest value (0.80%, 95% IC, 0.78% to 0.82%) during the sixth decade oflife. The incidence was higherin females (88.8%, 95% IC 0.44 to 0.49%). Among the identified risk factors for VTE in this population, classified according to the relative risk of them indirect. The most frequent were: bed rest for more than 3 days and history of DVT or pulmonary embolism. The frequency of occurrence of these was different depending on the VTE was acquired in the community or during hospitalization, but only a history of DVT or pulmonary embolism was significantly more frequent in those patients admitted to hospital with VTE (p=0.007). CONCLUSION VTE is a preventable disease. However, only one third of patient developed VTE in the University Hospital and Intensive Care Unit of INT, had indicated treatment or prophylaxis with ASA and warfarin .

Palabras clave : VTE; diagnosis; mortality.

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