Factores predictivos de riesgo para desarrollar enfermedad tromboembólica venosa en pacientes oncológcos en quimioterapia
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La enfermedad tromboembólica venosa (ETV), proceso caracterizado por la formación de
un trombo en el interior del sistema venoso cuya presentación clínica está constituida por la
trombosis venosa profunda (TVP) y el trombo embolismo pulmonar (TEP) se ve asociado a
enfermedades oncológicas; OBJETIVO: Determinar los principales factores de riesgo que
podrían predecir desarrollo de enfermedad tromboembólica venosa en pacientes
oncológicos del hospital de especialidades “Dr. Abel Gilbert Pontón” que se hallan en
tratamiento de quimioterapia durante el periodo enero 2018 a diciembre 2019.
METODOLOGÍA: Estudio retrospectivo cuantitativo de corte transversal, regresión
logística simple, en el contexto de un análisis univariado y multivariado. La unidad de
análisis es el hospital de especialidades “DR. ABEL GILBERT PONTON” en el periodo de
1 de enero del 2017 al 31 de diciembre del 2019. En pacientes de ambos sexos entre 20 y
70 años con diagnóstico de tumor maligno solido no hematológico en quimioterapia.
RESULTADOS: De setecientos ochenta y seis casos con una mediana de edad de 57 (49 –
63) años, el 1.78% desarrollaron enfermedad tromboembolica venosa y eran quienes
también presentaron ECOG más severo (P<.001); los tumores que con mayor frecuencia
desarrollaron ETV fueron: cáncer de mama con 61.5%, seguido de tumor maligno de
cuello uterino con 14.5% y finalmente algún tumor maligno del tubo digestivo o glándulas
anexas con 11.5% (P=0.017); el 64% de los pacientes con ETV tenían tumor visible a la
inspección (P<.001). La frecuencia de casos con trombocitosis fue significativamente
superior entre quienes presentaron enfermedad tromboembólica, observándose en 8/14
casos (P<.001). Entre los pacientes con enfermedad tromboembólica venosa el 25.7%
recibió quimioterapia ambulatoria y 64.3%, quimioterapia intrahospitalaria (P<.001).
Conclusiones: A partir del análisis univariado y multivariado pudo verificarse que tanto un
estado funcional más grave, como la realización de quimioterapia intrahospitalaria son los
factores principales de riesgo para predecir desarrollo de enfermedad tromboembólica
venosa
Venous thromboembolic disease (VTE), is a process characterized by the formation of a thrombus within the venous system whose clinical presentation is constituted by deep vein thrombosis (DVT) and pulmonary embolism (PE), this pathology is associated with oncological diseases. OBJECTIVE: To determine the main risk factors that could predict the development of venous thromboembolic disease in cancer patients at the specialty hospital “Dr. Abel Gilbert Pontón” who are undergoing chemotherapy treatment during the period January 2017 to December 2019. METHODOLOGY: A quantitative retrospective cross-sectional study, simple logistic regression, in the context of a univariate and multivariate analysis. The unit of analysis is the specialty hospital “DR. ABEL GILBERT PONTON” in the period from January 1, 2018 to December 31, 2019. Patients of both sexes between 20 and 70 years of age with a diagnosis of non-hematological solid malignant tumor on chemotherapy. RESULTS: Of seven hundred and eighty-six cases with a median age of 57 (49 - 63) years, 1.78% developed venous thromboembolic disease and were the ones who also presented more severe ECOG (P <.001); The tumors that most frequently developed VTE were: breast cancer with 61.5%, followed by a malignant cervical tumor with 14.5% and finally some malignant tumor of the digestive tract or adjoining glands with 11.5% (P = 0.017); 64% of the patients with VTE had a tumor visible on inspection (P <.001). The frequency of cases with thrombocytosis was significantly higher among those with thromboembolic disease, observed in 8/14 cases (P <.001). Among the patients with venous thromboembolic disease, 25.7% received outpatient chemotherapy and 64.3% received in-hospital chemotherapy (P <.001). CONCLUSIONS: From the univariate and multivariate analysis, it was possible to verify that both a more severe functional status and the performance of in-hospital chemotherapy are the main risk factors for predicting the development of venous thromboembolic disease.
Venous thromboembolic disease (VTE), is a process characterized by the formation of a thrombus within the venous system whose clinical presentation is constituted by deep vein thrombosis (DVT) and pulmonary embolism (PE), this pathology is associated with oncological diseases. OBJECTIVE: To determine the main risk factors that could predict the development of venous thromboembolic disease in cancer patients at the specialty hospital “Dr. Abel Gilbert Pontón” who are undergoing chemotherapy treatment during the period January 2017 to December 2019. METHODOLOGY: A quantitative retrospective cross-sectional study, simple logistic regression, in the context of a univariate and multivariate analysis. The unit of analysis is the specialty hospital “DR. ABEL GILBERT PONTON” in the period from January 1, 2018 to December 31, 2019. Patients of both sexes between 20 and 70 years of age with a diagnosis of non-hematological solid malignant tumor on chemotherapy. RESULTS: Of seven hundred and eighty-six cases with a median age of 57 (49 - 63) years, 1.78% developed venous thromboembolic disease and were the ones who also presented more severe ECOG (P <.001); The tumors that most frequently developed VTE were: breast cancer with 61.5%, followed by a malignant cervical tumor with 14.5% and finally some malignant tumor of the digestive tract or adjoining glands with 11.5% (P = 0.017); 64% of the patients with VTE had a tumor visible on inspection (P <.001). The frequency of cases with thrombocytosis was significantly higher among those with thromboembolic disease, observed in 8/14 cases (P <.001). Among the patients with venous thromboembolic disease, 25.7% received outpatient chemotherapy and 64.3% received in-hospital chemotherapy (P <.001). CONCLUSIONS: From the univariate and multivariate analysis, it was possible to verify that both a more severe functional status and the performance of in-hospital chemotherapy are the main risk factors for predicting the development of venous thromboembolic disease.
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PACIENTES INCURABLES, ENFERMEDAD TROMBOEMBOLICA VENOSA, PREDICTOR, QUIMIOTERAPIA, FACTORES DE RIESGO, HOSPITAL DE ESPECIALIDADES GUAYAQUIL DR. ABEL GILBERT PONTON, CANTON GUAYAQUIL, ECUADOR