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Predictores de sangrado durante el tratamiento con heparina
JAMA
|September 12, 1980
Resumen
La terapia con heparina sódica puede causar sangrado, especialmente en mujeres, pacientes gravemente enfermos y aquellos que toman aspirina. El consumo excesivo de alcohol aumenta el riesgo de sangrado mayor durante la heparinización.
Área de la Ciencia:
- Farmacología Farmacología.
- La medicina clínica es la medicina clínica.
- La seguridad del paciente.
Sus antecedentes:
- La heparina sódica es un anticoagulante ampliamente utilizado.
- Comprender los riesgos de sangrado asociados con el tratamiento con heparina es crucial para la seguridad del paciente.
- La identificación de los factores de riesgo específicos del paciente puede mejorar los protocolos de tratamiento con heparina.
Objetivo del estudio:
- Para investigar la incidencia y los factores de riesgo de sangrado durante la terapia con heparina sódica.
- Para diferenciar los factores asociados con los eventos de sangrado mayor versus menor.
- Para evaluar el riesgo acumulado y el momento de los episodios de sangrado.
Principales métodos:
- Análisis retrospectivo de 2.656 pacientes que recibieron heparina sódica.
- Identificación de la demografía de los pacientes, las comorbilidades y los medicamentos concomitantes.
- Análisis estadístico para determinar los efectos relacionados con la dosis y las asociaciones de factores de riesgo.
Principales resultados:
- El sangrado durante el tratamiento con heparina está relacionado con la dosis y es más común en mujeres y pacientes gravemente enfermos.
- El uso concomitante de aspirina y el consumo excesivo de alcohol aumentan significativamente el riesgo de sangrado, especialmente el sangrado mayor.
- El riesgo acumulado de siete días para cualquier sangrado fue del 9,1%, con el riesgo más alto observado en el tercer día de la administración de heparina.
Conclusiones:
- La terapia con heparina sódica requiere un monitoreo cuidadoso de la hemorragia, especialmente en los grupos de pacientes de alto riesgo.
- Se recomienda el ajuste de la dosis y la administración con precaución con aspirina o en bebedores de alcohol pesado.
- El reconocimiento temprano de los factores de riesgo de sangrado puede mitigar los eventos adversos durante la anticoagulación.
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