Abstract
Thromboembolic disease is the main preventable cause of in-hospital death. Approximately 10% of nosocomial deaths are attributable to pulmonary embolism and in most cases, the diagnosis is not suspected before the autopsy. There are cost effective measures to decrease the incidence of thromboembolic disease. Pharmacological prophylaxis decreases the incidence of deep venous thrombosis by 65% and the incidence of pulmonary embolism by 35 to 55%. Despite this data and the presence of clinical guidelines, prophylaxis of thromboembolic disease is used only in 40% of medical patients and in 65% of surgical patients with recommended indications. We review the evidence that supports the use of thromboprophylaxis and the different strategies that may increase the compliance of physicians with its use. A protocol implemented in our institution is also proposed.
Highlights
Correspondencia a: Andrés Aizman Sevilla Marcoleta 367. 5° piso
10% of nosocomial deaths are attributable to pulmonary embolism and in most cases, the diagnosis is not suspected before the autopsy
There are cost effective measures to decrease the incidence of thromboembolic disease
Summary
Profilaxis de enfermedad tromboembólica en pacientes hospitalizados con patología médica, estrechando la brecha entre las guías y la práctica clínica. Pharmacological prophylaxis decreases the incidence of deep venous thrombosis by 65% and the incidence of pulmonary embolism by 35 to 55%. Despite this data and the presence of clinical guidelines, prophylaxis of thromboembolic disease is used only in 40% of medical patients and in 65% of surgical patients with recommended indications. La enfermedad tromboembólica (ETE), constituida por la trombosis venosa profunda (TVP) y el tromboembolismo pulmonar (TEP), tiene una incidencia 100 a 130 veces mayor en pacientes hospitalizados en comparación con la población general[1]. Diversos estudios han demostrado que la profilaxis farmacológica con heparinas es segura y eficaz, logrando reducciones del riesgo relativo de TVP y TEP de 40 a 70%8-10, constituyendo además una medida costo-efectiva[1]. La implementación de estrategias locales que faciliten el uso sistemático de tromboprofilaxis en pacientes médicos, contribuirá a disminuir en forma significativa la cantidad de eventos tromboembólicos asociados a hospitalización
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