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Tromboembolismo venoso durante la enfermedad activa y remisión en la enfermedad inflamatoria intestinal: un estudio
Matthew J Grainge1, Joe West, Timothy R Card
1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. matthew.grainge@nottingham.ac.uk
Lancet (London, England)
|February 13, 2010
Resumen
Los pacientes con enfermedad inflamatoria intestinal (EII) se enfrentan a un riesgo significativamente mayor de tromboembolismo venoso (TEV), especialmente durante los brotes de la enfermedad. Esto pone de relieve la necesidad de la profilaxis de TEV en pacientes con EII.
Área de la Ciencia:
- Gastroenterología y Gastroenterología.
- La medicina vascular es una medicina vascular.
- Epidemiología La epidemiología.
Sus antecedentes:
- La enfermedad inflamatoria intestinal (EII) se asocia con un mayor riesgo de tromboembolismo venoso (TEV).
- El riesgo de TEV puede variar dependiendo de la fase de actividad de la EII.
Objetivo del estudio:
- Cuantificar de manera prospectiva el riesgo de TEV en pacientes con EII.
- Evaluar cómo difiere el riesgo de TEV durante las diferentes fases de actividad de la EII.
Principales métodos:
- Un estudio de cohorte utilizando la Base de Datos de Investigación de Práctica General.
- El emparejamiento de pacientes con EII con controles y el uso de análisis de regresión de Cox con covariables que varían en el tiempo.
- Definir un brote de la enfermedad como los 120 días después de la prescripción de corticosteroides.
Principales resultados:
- Los pacientes con EII tenían un riesgo 3.4 veces mayor de TEV en comparación con los controles.
- Durante los brotes de EII, el riesgo de TEV fue significativamente mayor (HR 8.4).
- El riesgo relativo de TEV durante los brotes fue mayor en los períodos no hospitalizados que en los hospitalizados.
Conclusiones:
- El estudio demuestra un riesgo sustancialmente elevado de TEV en pacientes con EII, particularmente durante los brotes.
- Los ensayos de profilaxis primaria para TEV en pacientes con EII están justificados para explorar estrategias preventivas.
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