Experiencia en el uso de tromboprofilaxis farmacológica en un hospital colombiano de tercer nivel

Martínez-Montalvo, Carlos Mauricio; Mondragón-Cardona, Álvaro; Maluche-Osorio, Alejandro; Tovar-Medina, Juan P.; Salamanca-Muñoz, Daniela F.; Trujillo-Silva, Gina C.; Quintero-Díaz, José M.

doi:10.35663/amp.2018.352.442

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…55 • Another tool that evaluates the risk of bleeding in subjects about to undergo anticoagulant treatment is the IMPROVE scale, which establishes a high bleeding risk when the score is > 7. 56 Apropos of the difference in bleeding risk by virtue of the different types of anticoagulants, the SELECT-D study, comparing dalteparin to rivaroxaban in oncology patients diagnosed with VTE, displayed a higher rate of bleeding with rivaroxaban than with dalteparin, with MB predominantly at the gastroesophageal level and clinically relevant non-major bleeding more common at the level of the bladder and lower gastrointestinal. 25 These data were corroborated by the meta-analysis published by Mulder et al in 2020; thus, DOACs should be used with caution in individuals at high risk of bleeding.…”

Section: Thrombocytopeniamentioning

confidence: 99%

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Venous Thromboembolism In Cancer Patients: “From Evidence to Care”

Fernández

Brozos-Vázquez

Campos

et al. 2022

Clin Appl Thromb Hemost

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This article seeks to review the current status of treatment and prevention of venous thromboembolic disease (VTE) in cancer patients after the addition of direct oral anticoagulants (DOAC) to the therapeutic arsenal available. The suitability of DOAC use in complex clinical situations, poorly represented in clinical trials, is controversial and difficult for care activity, making the recommendations in clinical practice guidelines the focus of special attention in this area. Recently, several randomized trials have compared low molecular weight heparin (LMWH) to DOAC for the management of CAT. Potential drug interactions with DOACs or the increased risk of bleeding in intraluminal tumors require special precautions, as do metastatic or primary brain disease and comorbid conditions, such as renal or liver failure, which are not suitably represented in pivotal studies. Furthermore, few data are available for situations involving elevated bleeding risk, with thrombocytopenia levels below the inclusion criterion of clinical trials, or recurrence during active anticoagulant therapy. Similarly, it is less clear that patients and physicians accept the presumption that oral DOAC administration is more convenient than subcutaneous LMWH, particularly when drug absorption may be compromised. The non-inclusion or under-representation of patients at higher risk for complications with anticoagulation in randomized clinical trials, makes their use complex in certain situations in health care. This paper provides a practical review of current clinical guideline recommendations regarding LMWH and/ or DOAC to treat and prevent CAT, as well as the most controversial clinical conditions for their use.

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Section: Thrombocytopeniamentioning

confidence: 99%

“…55 Another tool that evaluates the risk of bleeding in subjects about to undergo anticoagulant treatment is the IMPROVE scale, which establishes a high bleeding risk when the score is > 7. 56 …”

Section: Special Situationsmentioning

confidence: 99%

Venous Thromboembolism In Cancer Patients: “From Evidence to Care”

Fernández

Brozos-Vázquez

Campos

et al. 2022

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

show abstract

Del papel a la práctica: adherencia a las guías de práctica clínica de tromboprofilaxis en pacientes quirúrgicos en Colombia

2021

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El desarrollo del tromboembolismo venoso (TEV) en pacientes quirúrgicos representa un serio problema de salud pública, pues aumenta las tasas de morbimortalidad y los costos asociados con la atención intrahospitalaria de esta población. No obstante lo anterior, y a pesar de que su efectividad ha sido demostrada, en Colombia las medidas profilácticas no son utilizadas de forma adecuada en estos pacientes. Una posible causa de esta situación es la pobre adherencia de los profesionales de la salud a las guías de práctica clínica (GPC) para la prevención del TEV. En este sentido, se han descrito varias aproximaciones metodológicas para lograr una adecuada implementación de la tromboprofilaxis al transformar los comportamientos de los médicos. Sin embargo, para lograr este propósito es necesario considerar de forma integral las barreras multifactoriales y las condiciones sociológicas que subyacen a este problema. Se sabe que una mejor adherencia a las GPC de profilaxis de TEV conduce a una mejor práctica clínica. Por lo tanto, el objetivo de este artículo es realizar un análisis reflexivo de las causas y posibles soluciones de la baja adherencia de los profesionales de la salud en Colombia a dichas guías.

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Experiencia en el uso de tromboprofilaxis farmacológica en un hospital colombiano de tercer nivel

Cited by 2 publications

References 20 publications

Venous Thromboembolism In Cancer Patients: “From Evidence to Care”

Venous Thromboembolism In Cancer Patients: “From Evidence to Care”

Del papel a la práctica: adherencia a las guías de práctica clínica de tromboprofilaxis en pacientes quirúrgicos en Colombia

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