Palabras clave
Traumatismo múltiple
Enfermedades vasculares
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Resumen
Objetivo: El objetivo del presente estudio es comparar el uso de los diferentes anticoagulantes en la tromboprofilaxis de pacientes con trauma. Métodos: Esta es una revisión sistemática de la literatura, realizada en las bases de datos MEDLINE (PubMed), Cochrane y Scopus, utilizando sólo estudios observacionales analíticos o experimentales de los últimos 10 años, de acuerdo con las recomendaciones de los Elementos de Información Preferidos para Revisiones Sistemáticas y Metaanálisis (PRISMA), y registrada en la base de datos PROSPERO. Resultados: Se incluyeron 27 artículos, en su mayoría estudios de cohortes retrospectivos, con traumatismos de carácter ortopédico o contuso, y con mayor porcentaje de pacientes masculinos, con una edad promedio entre 40 y 60 años. El anticoagulante más utilizado fue la heparina de bajo peso molecular (HBPM) y el principal método diagnóstico fue la ecografía (USG). Finalmente, se observó un mejor pronóstico con el uso de HPBM en comparación con otros medicamentos tradicionales. Sin embargo, al compararlo con rivaroxabán, se encontraron divergencias entre los estudios. Consideraciones finales: En la tromboprofilaxis hay predominio del uso de heparinas, y la HBPM reduce más la incidencia de TEV y TVP. Los DOAC tienen superioridad farmacodinámica y efectos adversos más leves y, por lo tanto, se consideran buenas alternativas en la tromboprofilaxis.
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