Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general / Venous thromboembolism prevention in non-surgical adult patients admitted in a general hospital

Los pacientes adultos internados por una enfermedad no quirúrgica tienen un riesgo alto de padecer una tromboembolia venosa y pueden desarrollar alguna forma de esta enfermedad cuando no reciben un tratamiento preventivo adecuado. Los objetivos de este estudio prospectivo, analítico, observacional y transversal, fueron: 1) determinar cuál es el porcentaje de pacientes adultos internados por una enfermedad aguda no quirúrgica en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, que tienen indicación de tromboprofilaxis, 2) establecer cuántos de ellos reciben un tratamiento preventivo para la tromboembolia venosa, y 3) comprobar cuántos estaban medicados con alguna forma de tromboprofilaxis sin tener causas que justificaran este tratamiento. Se estudiaron 93 pacientes durante un lapso de 72 horas consecutivas. Se encontró que el 90.3% de ellos necesitaba un tratamiento preventivo para la tromboembolia venosa y el 76.2% de estos enfermos recibían tromboprofilaxis farmacológica. Un 33.3% de los pacientes internados tenía indicado un tratamiento farmacológico preventivo sin tener una causa que justificara esta prescripción. El porcentaje encontrado de pacientes tratados con tromboprofilaxis es más alto que el comunicado en otros estudios observacionales.

Adult patients hospitalized for a non-surgical condition, usually have a high risk of venous thromboembolism and may develop some form of this disease when they do not receive appropriate preventive treatment. The objectives of this prospective, analytical, observational and cross-sectional study were: 1) to determine what percentage of adult patients hospitalized for a non-surgical acute condition at the Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, had indication for preventive thromboprophylaxis, 2) to establish how many of them had been prescribed a preventive treatment of venous thromboembolism, 3) to establish how many of them had been prescribed a preventive treatment of venous thromboembolism without having reasons to justify the treatment. The study was performed on 93 patients for 72 consecutive hours. It resulted in 90.3% in need of preventive treatment for venous thromboembolism and 76.2% of these patients had received pharmacological thromboprophylaxis. A 33.3% of the studied patients had received preventive pharmacological treatment without having a proper indication. In this study, the percentage of patients treated is higher than in those reported in other published observational studies.

Tromboembolismo venoso no ciclo gravídico puerperal / Venous thromboembolism in pregnant-puerperal cycle

Tromboembolismo pulmonar e trombose venosa profunda são os doiscomponentes da síndrome de tromboembolismo venoso, atualmente considerada uma das principais causasde morbimortalidade materna no mundo ocidental. Durante a gestação, classicamente conhecida como umestado de hipercoagulação, a frequência de fenômenos tromboembólicos é ainda maior. A presença de fatoresde risco para o tromboembolismo adicionada à gravidez requer atenção especial, visto que diagnóstico tardio,tratamento inadequado ou tardio e profilaxia imprópria podem levar à morte materna. Esta revisão tem comoobjetivo esclarecer os fatores de risco relacionados a fenômenos tromboembólicos na gestação, os métodos dediagnóstico disponíveis, medidas de profilaxia e tratamentos atualmente recomendados.

Pulmonary thromboembolism and deep vein thrombosis are the twocomponents of Venous Thromboembolism Syndrome, considered nowadays as one of the leading causes ofmaternal morbimortality in the occidental world. During the gestational period, which is classically known as ahipercoagulable state, the frequency of thromboembolic events is even bigger. The presence of risk factors forthromboembolism added to pregnancy demands special attention, since late diagnosis, inadequate or delayedtreatment and improper prophylaxis may lead to maternal death. The purpose of this review is to present the riskfactors related to thromboembolic events in the gestational period, to discuss available diagnostic and prophylaxismethods and treatments currently recommended.