Escala de Caprini como predictor de tromboembolismo venoso en pacientes post cirugía abdominal, Unidad de Cuidados Intensivos del Hospital Luis Vernaza, enero a julio 2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: El tromboembolismo venoso (TEV) es un problema relativamente común y se asocia a disminución de la sobrevida y altos costos de salud. Existen algunos scores validados para el riesgo de TEV como la Escala Caprini, que sirve para valorar la probabilidad de TEV en población quirúrgica ubicando a los pacientes en niveles de riesgo y aconseja la utilización de métodos de tromboprofilaxis acorde al mismo. Objetivos: Determinar la utilidad de la escala de CAPRINI como predictor de tromboembolismo venoso en pacientes post cirugía abdominal que fueron intervenidos en el Hospital Luis Vernaza. Metodología: Se realizó un estudio retrospectivo en el Hospital Luis Vernaza en el período comprendido entre enero y Julio del año 2016. El universo lo constituyeron los pacientes ingresados en el área de Medicina Crítica, que fueron admitidos al mismo por patología quirúrgica abdominal; y que durante los primeros 30 días de hospitalización sufrieron cuadro de TEV. Los datos de estudio se obtuvieron de la Historia clínica. Resultados: De los 7 pacientes obtenidos en el estudio se encontró predominio del género masculino con el 71.42%, con grupo de edad más frecuente entre los 61 – 80 años con un total de 5 casos (71.43%) siendo la edad promedio 69.43 años. Acorde a la distribución según el tipo de Cirugía se encontró que el 70% de los casos correspondieron a procedimientos programados. Acorde a los grupos de riesgo según la escala de CAPRINI encontramos 4: Riesgo muy bajo, Riesgo Bajo, dichos rubros en los que no se encontró ningún caso; Riesgo moderado correspondiente al 14.29% y Riesgo alto con un total del 85.71%. Se observó relación entre la ausencia de tromboprofilaxis y el alto riesgo de CAPRINI para la aparición de TEV; además se encontró que de este grupo sólo 3 recibieron tromboprofilaxis farmacológica. Conclusiones: Se observó que 6 de los 7 pacientes tenían alto riesgo de TEV y 3 de ellos lo presentaron pese a profilaxis usada; sin embargo los datos no son suficientes para validar el uso de la escala.
PALABRAS CLAVES: Tromboembolismo venoso, Escala de Caprini, Unidad cuidados intensivos, tromboprofilaxis, cirugía abdominal
Introduction: Venous thromboembolism (VTE) is a relatively common problem and is associated with decreased survival and high health costs. There are some validated scores for the risk of VTE, such as the Caprini Scale, which serves to assess the likelihood of VTE in the surgical population by placing patients at risk levels and advises thromboprophylaxis methods in accordance with it. Objectives: To determine the utility of the CAPRINI score as a predictor of venous thromboembolism in post-abdominal surgery patients at the Luis Vernaza Hospital. Methodology: The present study was retrospective, hold at the Luis Vernaza Hospital between January and July of 2016. The universe was constituted by patients admitted to the Critical Care area, who have been admitted to it due to abdominal surgical pathology; and that during the first 30 days of hospitalization have suffered from VTE. The study data were obtained from the clinical records. Results: Of the 7 patients obtained in the study, a predominance of males was found with 71.42%, with the most frequent age group between 61 and 80 years old, with a total of 5 cases (71.43%), with an average age of 69.43 years. According to the distribution to the type of surgery, it was found that 70% of the cases corresponded to programmed procedures. According to the risk groups following CAPRINI score we find 4: Very low risk, Low risk, those items in which no case was found; Moderate risk corresponding to 14.29% and High risk with a total of 85.71%. We observed a relationship between the absence of thromboprophylaxis and the high risk of CAPRINI for the appearance of VTE and found that only 3 high-risk patients received pharmacological thromboprophylaxis. Conclusions: It was observed that 6 of the 7 patients had high risk of VTE and 3 of them presented it despite prophylaxis, however the data are not enough to validate the use of CAPRINI Score for VTE. KEYWORDS: Venous thromboembolism, Caprini score, Intensive care unit, thromboprophylaxis, abdominal surgery
Introduction: Venous thromboembolism (VTE) is a relatively common problem and is associated with decreased survival and high health costs. There are some validated scores for the risk of VTE, such as the Caprini Scale, which serves to assess the likelihood of VTE in the surgical population by placing patients at risk levels and advises thromboprophylaxis methods in accordance with it. Objectives: To determine the utility of the CAPRINI score as a predictor of venous thromboembolism in post-abdominal surgery patients at the Luis Vernaza Hospital. Methodology: The present study was retrospective, hold at the Luis Vernaza Hospital between January and July of 2016. The universe was constituted by patients admitted to the Critical Care area, who have been admitted to it due to abdominal surgical pathology; and that during the first 30 days of hospitalization have suffered from VTE. The study data were obtained from the clinical records. Results: Of the 7 patients obtained in the study, a predominance of males was found with 71.42%, with the most frequent age group between 61 and 80 years old, with a total of 5 cases (71.43%), with an average age of 69.43 years. According to the distribution to the type of surgery, it was found that 70% of the cases corresponded to programmed procedures. According to the risk groups following CAPRINI score we find 4: Very low risk, Low risk, those items in which no case was found; Moderate risk corresponding to 14.29% and High risk with a total of 85.71%. We observed a relationship between the absence of thromboprophylaxis and the high risk of CAPRINI for the appearance of VTE and found that only 3 high-risk patients received pharmacological thromboprophylaxis. Conclusions: It was observed that 6 of the 7 patients had high risk of VTE and 3 of them presented it despite prophylaxis, however the data are not enough to validate the use of CAPRINI Score for VTE. KEYWORDS: Venous thromboembolism, Caprini score, Intensive care unit, thromboprophylaxis, abdominal surgery
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Tromboembolia, Escala de Caprini, Cirugía abdominal, Período posoperatorio, Hospital Luis Vernaza, Cantón Guayaquil, Ecuador, Unidades de Cuidados Intensivos