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Evaluación del Riesgo de Tromboembolismo Venoso y Profilaxis en Pacientes con Traumatismos
Parichat Tanmit1, Patharat Singthong1, Phati Angkasith1
1Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
International journal of environmental research and public health
|January 28, 2026
Resumen
La evaluación del riesgo de tromboembolismo venoso (VTE) es vital para el manejo de la profilaxis. Equilibrar la profilaxis de VTE con el riesgo de sangrado es crucial, especialmente en pacientes con traumatismos de alto riesgo.
Área de la Ciencia:
- Atención de traumatismos y manejo de enfermedades críticas. Investigación vascular y de trombosis. Seguridad del paciente y resultados clínicos.
Sus antecedentes:
- El tromboembolismo venoso (VTE) presenta riesgos significativos de morbilidad y mortalidad. Las lesiones pueden activar múltiples vías que conducen a la trombosis venosa. Los protocolos de profilaxis son esenciales para prevenir las complicaciones de la VTE.
Objetivo del estudio:
- Evaluar los resultados del tromboembolismo venoso utilizando el perfil de evaluación de riesgos de Greenfield. Determinar la asociación entre la puntuación de Greenfield y las complicaciones hemorrágicas en pacientes con traumatismos.
Principales métodos:
- Estudio de cohorte retrospectivo de pacientes con traumatismos de 15 años o más (enero de 2020 - diciembre de 2022). Los criterios de exclusión incluyeron hospitalización <24 horas o muerte durante el tratamiento de emergencia. Se utilizó el perfil de evaluación de riesgos de Greenfield para categorizar el riesgo de VTE.
Principales resultados:
- Se inscribieron 580 casos; el 46,6% tenía un alto riesgo de VTE. El 30,4% de los pacientes de alto riesgo recibió tromboprofilaxis farmaco-mecánica. Todos los casos de VTE (3% del total) eran de alto riesgo según la puntuación de Greenfield; el sangrado mayor ocurrió con hematoma subdural.
Conclusiones:
- La evaluación del riesgo de VTE es fundamental para optimizar las estrategias de profilaxis. Equilibrar la profilaxis farmacológica frente al riesgo de sangrado es esencial para la seguridad del paciente.
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