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Adherencia global a las guías internacionales de tromboprofilaxis venosa en cirugía ortopédica mayor. Revisión sistemática de la literatura

dc.contributor.advisorMorón Duarte, Lina Sofía
dc.creatorFarfán, Miguel Andrés
dc.creatorBautista, María Piedad
dc.creatorBonilla, Guillermo
dc.creatorRojas, Jorge Luis
dc.creatorLlinás, Adolfo
dc.creatorNavas, José
dc.creator.degreeEspecialista en Ortopedia y Traumatología FSFB
dc.date.accessioned2017-08-29T19:36:07Z
dc.date.available2017-08-29T19:36:07Z
dc.date.created2016-03-15
dc.date.issued2016
dc.descriptionAntecedentes: El aumento del riesgo de enfermedad tromboembólica después de cirugía ortopédica mayor (COM) ha sido ampliamente descrito en la literatura y las guías de práctica clínica incluyen recomendaciones para disminuir este riesgo. Sin embargo, no existe evidencia de una implementación sistemática de estas recomendaciones. El objetivo de este estudio es identificar y comparar la adherencia a las últimas 4 ediciones de las guías ACCP para tromboprofilaxis. Metodología: Se realizó una búsqueda sistemática de la literatura (metodología PRISMA) en las bases de datos Ovid, PubMed y Embase. Se incluyeron estudios que evaluaran la adherencia a las guías ACCP durante los últimos 10 años. Los desenlaces evaluados fueron: adherencia global, intrahospitalaria y extendida y calcularon proporciones para cada desenlace. Resultados: De 3993 títulos identificados, 13 artículos que incluyen datos de 35.310 pacientes fueron seleccionados para el análisis. Estos estudios reportan la adherencia a la 6a, 7a y 8a edición de las guías ACCP. No se encontraron estudios para la 9a edición. La adherencia global a las recomendaciones fue del 54.38%, 90.1% intrahospitalaria y 66.72% extendida. La adherencia global para las ediciones 6, 7 y 8 fue de 59.63%, 55.6% y 42.0% respectivamente. La diferencia en la adherencia entre las guías 6 y 8 fue de -17,6% (p <0.005). Conclusión: Observamos una disminución significativa en la tasa de adherencia a las recomendaciones a través del tiempo. Debido a que la adherencia a la tromboprofilaxis extendida es significativamente menor, se requieren esfuerzos adicionales para aumentar esta adherencia. Nivel de evidencia: IIspa
dc.description.abstractIntroduction: Increased risk of venous thromboembolism following major orthopedic surgery (MOS) is well de- scribed. The American Academy of Chest Physician (ACCP) has generated evidence-based recommendations for thromboprophylaxis; however, there is a gap between guidelines recommendations and clinical practice. The aim of this study is to compare worldwide adherence rates to the last 4 editions of ACCP guidelines for thromboprophylaxis after MOS. Materials and methods: A systematic review of literature and meta-analysis was performed. Studies reporting ad- herence to ACCP guidelines between January 2004 and October 2014 were included. Adherence rates after MOS for in-hospital (IH), extended (EXT), and global thromboprophylaxis (in-hospital plus extended) were assessed. Results: Of 3993 titles, 13 studies reporting data of 35, 303 patients were selected. Studies assessing the 6th, 7th or 8th editions of ACCP guidelines were found. No studies evaluating the 9th edition were available. For MOS, global adherence rates for the 6th, 7th and 8th editions were 62% (95% CI: 61%–63%), 70% (95% CI: 69%–71%), and 42% (95% CI: 41%–43%), respectively. Likewise, in-hospital adherence was 52% (95% CI: 50%–54%), 51% (95% CI: 50%– 52%) and 85% (95% CI: 84%–86%). For extended prophylaxis, adherence rates were reported only for the 8th edition (59%; 95% CI: 58%–60%). Conclusions: Adherence to ACCP recommendations for thromboprophylaxis during hospitalization has increased over time. Nevertheless, adherence rates to global thromboprophylaxis decrease due to an insufficient imple- mentation of recommendations after discharge. eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_13727
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/13727
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Ortopedia y Traumatología FSFBspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectTerapia anticoagulantespa
dc.subjectGuías de práctica clínicaspa
dc.subjectHeparina de bajo peso molecularspa
dc.subjectPrevenciónspa
dc.subjectEmbolismo pulmonarspa
dc.subjectTromboembolismo venosospa
dc.subjectAntagonistas de la Vitamina Kspa
dc.subject.ddcVarias ramas de la medicina, Cirugía
dc.subject.decsArtroplastiaspa
dc.subject.decsFracturas de Caderaspa
dc.subject.decsArtroplastia de Reemplazo de Caderaspa
dc.subject.decsTromboembolia Venosaspa
dc.subject.keywordArthroplastyeng
dc.subject.keywordReplacementeng
dc.subject.keywordHip Fractureseng
dc.subject.keywordPrevention & controleng
dc.subject.keywordVenous Thromboembolismeng
dc.subject.keywordGuideline Adherenceeng
dc.titleAdherencia global a las guías internacionales de tromboprofilaxis venosa en cirugía ortopédica mayor. Revisión sistemática de la literaturaspa
dc.title.TranslatedTitleWorldwide adherence to ACCP guidelines for thromboprophylaxis after major orthopedic surgery: A systematic review of the literature and meta-analysiseng
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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