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Asociación entre la actividad física y el riesgo de sangrado en niños con hemofilia
Carolyn R Broderick1, Robert D Herbert, Jane Latimer
1Sydney Medical School, University of Sydney, Sydney, NSW, Australia. c.broderick@unsw.edu.au
JAMA
|October 11, 2012
Resumen
La actividad física vigorosa está relacionada con un aumento moderado y temporal en el riesgo de sangrado para los niños con hemofilia. Sin embargo, el aumento general de las hemorragias asociadas con tales actividades es probablemente pequeño.
Área de la Ciencia:
- Hematología Pediátrica.
- Medicina Deportiva Medicina Deportiva es una especialidad de la medicina deportiva.
- Trastornos de la coagulación de la sangre Trastornos de la coagulación de la sangre Trastornos de la coagulación de la sangre Trastornos de la coagulación de la sangre
Sus antecedentes:
- La actividad física a menudo se restringe en los niños con hemofilia debido a las preocupaciones sobre el riesgo de sangrado.
- La magnitud exacta de este aumento en el riesgo de sangrado asociado con la actividad física sigue sin estar clara.
Objetivo del estudio:
- Para cuantificar el aumento transitorio en el riesgo de sangrado relacionado con la actividad física en pacientes pediátricos con hemofilia.
- Para analizar la asociación entre diferentes categorías de actividad física y eventos de sangrado.
Principales métodos:
- Un estudio de caso cruzado anidado dentro de una cohorte prospectiva de 104 niños (4-18 años) con hemofilia A o B.
- Las exposiciones a la actividad física en las 8 horas anteriores a una hemorragia se compararon con los períodos de control, con ajustes para los niveles de factor de coagulación.
- Las actividades se clasificaron por frecuencia e intensidad de colisión.
Principales resultados:
- Las actividades de categoría 2 (por ejemplo, baloncesto) mostraron un mayor riesgo de sangrado (OR, 2.7) en comparación con la inactividad.
- Las actividades de la categoría 3 (por ejemplo, lucha libre) demostraron un mayor aumento transitorio en el riesgo de hemorragia (OR, 3.7).
- Un aumento del 1% en los niveles del factor de coagulación se asoció con una disminución del 2% en la incidencia de hemorragias.
Conclusiones:
- La actividad física vigorosa se asocia transitoriamente con un aumento relativo moderado en el riesgo de hemorragia en niños y adolescentes con hemofilia.
- El aumento absoluto en el riesgo de sangrado atribuible a la actividad física es probablemente pequeño debido a la naturaleza transitoria del aumento de riesgo.
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