Mostrar el registro sencillo del ítem
Caracterización de los usuarios de la Clínica de anticoagulación del Hospital Militar Central
dc.contributor.advisor | Palomino, Gustavo Alejandro | spa |
dc.contributor.author | Hernández, Daniel Alberto | |
dc.coverage.spatial | Medicina | spa |
dc.date.accessioned | 2020-02-25T19:55:59Z | |
dc.date.available | 2020-02-25T19:55:59Z | |
dc.date.issued | 2019-11-07 | |
dc.identifier.uri | http://hdl.handle.net/10654/34920 | |
dc.description.abstract | Objetivo: Describir las características clínicas y eventos de sangrado de la población atendida por la clínica de anticoagulación en el Hospital Militar Central, discriminando por ocurrencia de sangrado y documentando los indicadores habituales de seguimiento. Metodología: Estudio descriptivo de serie de casos en los pacientes usuarios de la clínica de anticoagulación del Hospital Militar Central identificados formalmente en el programa a partir de enero de 2018. Se revisaron los registros clínicos de 335 pacientes, y se seleccionaron 305 pacientes por cumplir con los criterios de inclusión. Los datos fueron almacenados en hoja de cálculo de Excel se ingresaron a la base de datos de SPSS para el análisis final. Resultados: 305 pacientes cumplieron con los criterios de inclusión para el análisis. La mayor proporción de pacientes del estudio fueron hombres (56.8%), el promedio de edad se encontraba en la séptima década de la vida (65,9 años ± 16,9) y el índice de masa corporal era normal (24,1 kg/m 2 ± 2,6). El principal motivo de anticoagulación fue el tromboembolismo venoso seguido de la fibrilación auricular. Los pacientes que presentaron sangrado fueron predominantemente hombres y con diagnósticos asociados de insuficiencia cardiaca, diabetes mellitus, enfermedad pulmonar obstructiva crónica, enfermedad renal crónica, fibrilación auricular y portadores de prótesis valvular cardiaca mecánica; la causa de anticoagulación de estos pacientes fue la presencia de prótesis valvular cardiaca mecánica y la fibrilación auricular de origen valvular; el anticoagulante que más se asoció con sangrado fue la warfarina. Los indicadores identificados fueron: prevalencia de sangrado (14.09% con 43 eventos), 4.9% para sangrado mayor y 9.1% de sangrado menor; TTR promedio fue 42%, nuevos eventos tromboembólicos 4.2%, y la mortalidad general fue 1.4%. Conclusiones: La población atendida por la clínica de Anticoagulación del Hospital Militar Central presenta características clínicas y demográficas similares a otras poblaciones descritas bajo efectos de anticoagulantes. Las comorbilidades asociadas a sangrado de la población descrita ya se han identificado como factores de riesgo en diferentes estudios, por lo que nuestros hallazgos no se alejan de la descripción de la literatura. | spa |
dc.format | spa | |
dc.format.mimetype | application/pdf | spa |
dc.language.iso | spa | spa |
dc.language.iso | spa | spa |
dc.publisher | Universidad Militar Nueva Granada | spa |
dc.rights | Derechos Reservados - Universidad Militar Nueva Granada, 2020 | spa |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.5/co/ | spa |
dc.title | Caracterización de los usuarios de la Clínica de anticoagulación del Hospital Militar Central | spa |
dc.type | info:eu-repo/semantics/bachelorThesis | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.subject.lemb | CLINICA DE ANTICOAGULACION | spa |
dc.subject.lemb | ANTICOAGULANTES DIRECTOS | spa |
dc.subject.lemb | SANGRADO | spa |
dc.publisher.department | Facultad de Medicina | spa |
dc.type.local | Trabajo de grado | spa |
dc.description.abstractenglish | Objective: Describe the clinical characteristics and bleeding events of the population attended by the anticoagulation clinic at the Central Military Hospital, discriminating by occurrence of bleeding and documenting the usual monitoring indicators. Methodology: Descriptive study of a series of cases in patients using the anticoagulation clinic of the Central Military Hospital formally identified in the program as of January 2018. The clinical records of 335 patients were reviewed, and 305 patients were selected for compliance with Inclusion criteria The data was stored in Excel spreadsheet and entered into the SPSS database for final analysis. Results: 305 patients met the inclusion criteria for the analysis. The highest proportion of patients in the study were men (56,8%), the average age was in the seventh decade of life (65.9 years ± 16.9) and the body mass index was normal (24.1 kg / m2 ± 2 , 6). The main reason for anticoagulation was venous thromboembolism followed by atrial fibrillation. The patients who presented bleeding were predominantly men and with associated diagnoses of heart failure, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, atrial fibrillation and carriers of mechanical heart valve prostheses; The cause of anticoagulation of these patients was the presence of mechanical cardiac valve prosthesis and atrial fibrillation of valvular origin; The blood thinner that was most associated with bleeding was warfarin. The indicators identified were: prevalence of bleeding (14.09% with 43 events), 4.9% for major bleeding and 9.1% for minor bleeding; Average TTR was 42%, new thromboembolic events 4.2%, and overall mortality was 1.4%. Conclusions: The population served by the Anticoagulation clinic of the Central Military Hospital has similar clinical and demographic characteristics to other populations described under the effects of anticoagulants. The comorbidities associated with bleeding of the described population have already been identified as risk factors in different studies, so our findings do not depart from the description of the literature. | eng |
dc.title.translated | Characterization of the users of the Anticoagulation Clinic at the Central Military Hospital Bogotá | spa |
dc.subject.keywords | warfarin | spa |
dc.subject.keywords | direct anticoagulant | spa |
dc.subject.keywords | bleeding | spa |
dc.subject.keywords | thromboembolism | spa |
dc.subject.keywords | anticoagulation clinic | spa |
dc.publisher.program | Medicina interna | spa |
dc.creator.degreename | Especialista en Medicina interna | spa |
dc.subject.decs | CARDIOLOGIA | |
dc.subject.decs | FIBRILACION AURICULAR | |
dc.subject.decs | TROMBOEMBOLISMO | |
dc.description.degreelevel | Especialización | spa |
dc.publisher.faculty | Medicina y Ciencias de la Salud - Medicina interna | spa |
dc.type.dcmi-type-vocabulary | Text | spa |
dc.type.version | info:eu-repo/semantics/acceptedVersion | spa |
dc.rights.creativecommons | Atribución-NoComercial-SinDerivadas | spa |
dc.relation.references | Vidaillet H, Granada JF, Chyou et al. A population-based study of mortality among patients with atrial fibrillation or flutter. Am J Med 2002; 113: 365-70. | spa |
dc.relation.references | Wolf P, D’Agostino R, Belanger A et al. Probality of stroke: a risk profile from the Framingham study. Stroke 1991; 22: 312-8. | spa |
dc.relation.references | Wolf P, Dawber T, Thomas H et al. Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology 1978; 28: 973- 7. | spa |
dc.relation.references | Dickson BC. Venous thrombosis: on the history of Virchow´s triad. Univ Toronto Med J. 2004; 81:166. | spa |
dc.relation.references | B, Guenoun M, Hohnloser SH, Kolh P, Lip GY, Manolis A, McMurray J, Ponikowski P, Rosenhek R, Ruschitzka F, Savelieva I, Sharma S, Suwalski P, Tamargo JL, Taylor CJ, Van Gelder IC, Voors AA, Windecker S, Zamorano JL, Zeppenfeld K. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37:2893–2962. | spa |
dc.relation.references | Nutescu EA. The future of anticoagulation clinics. J Thrombosis and Thrombolysis 2003; 16 (1/2): 61-63. | spa |
dc.relation.references | Chiquette E, Amanto MG, Bussey HI. Comparison of an anticoagulation clinics with usual medical care anticoagulation control, patient outcomes and health care cost. Arch Intern Med 1998; 158: 1641-1647. | spa |
dc.relation.references | Anseel JE, Hughes RM. Involving models of warfarin management: anticoagulation clinics, patient selfmonitoring and patients self-management. Am Heart J 1996; 1095-1100. | spa |
dc.relation.references | Hirsh J, Dalen JE, Anderson DR, et al. Oral anticoagulants: mechanism of action, clinical effectiveness and optimal therapeutic range. Sixth ACCP. Consensus Conference on Antithrombotic Therapy. Chest 2001; 119 (1) (suppl): 8S- 21S. | spa |
dc.relation.references | Geoffrey D. Barnes, MD, MSc1, Brahmajee K. Nallamothu, MD, MPH1, Anne E. Sales, PhD, RN2, and James B. Froehlich, MD, MPH. Reimagining Anticoagulation Clinics in the Era of Direct Oral Anticoagulants. Circ Cardiovasc Qual Outcomes. 2016 March ; 9(2): 182–185. | spa |
dc.relation.references | Ocampo C, Hernández O, Velásquez C, Tobón I, Mejía F. La clínica de anticoagulación del Hospital Universitario San Vicente de Paúl: demografía, efectividad y complicaciones. Iatreia.2004;17(2):105---14. | spa |
dc.relation.references | Taboada LB, Silva LE, Montenegro AC. Beneficios de la clínica de anticoagulación. Acta Med Colomb. 2013;38:239---43. | spa |
dc.relation.references | Ligia P. Laverde, Sonia E. Gómez, Ana C. Montenegro, Alberto Lineros, Beatriz Wills y Andrés F. Buitrago. Experiencia de una clínica de anticoagulación. Rev Colomb Cardiol. 2015;22(5):224---230. | spa |
dc.relation.references | Hua Cao, Jianmei Wu, Jinhua Zhang. Outcomes of warfarin therapy managed by pharmacists via hospital anticoagulation clinic versus online anticoagulation clinic. International Journal of Clinical Pharmacy. 2018 Oct;40(5): 1072-1077. | spa |
dc.relation.references | Kaatz S. Determinants and measures of quality in oral anticoagulation therapy. J Thromb Thrombolysis. 2008 Feb;25(1):61-6. Epub 2007 Sep 29 | spa |
dc.relation.references | Corey S. Miller, BA, Sonia M Grandi, Avi Shimony, et al. Meta-Analysis of Efficacy and Safety of New Oral Anticoagulants (Dabigatran, Rivaroxaban, Apixaban) Versus Warfarin in Patients With Atrial Fibrilation. Am J Cardiol 2012;110:453-460 | spa |
dc.relation.references | van Walraven C, Jennings A, Oake N, et al. Effect of study setting on anticoagulation control: a systematic review and metaregression. Chest 2006; 129:1155. | spa |
dc.relation.references | Pisters Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010 Nov;138(5):1093-100. doi: 10.1378/chest.10-0134. Epub 2010 Mar 18. | spa |
dc.subject.proposal | clínica de anticoagulación | spa |
dc.subject.proposal | tromboembolismo | spa |
dc.subject.proposal | sangrado | spa |
dc.subject.proposal | anticoagulantes directos | spa |
dc.subject.proposal | warfarina | spa |
Archivos en el ítem
Este ítem aparece en la(s) siguiente(s) colección(ones)
-
Medicina Interna [38]