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Dímero d y ultrasonografía de miembros inferiores como factores pronósticos de trombosis venosa profunda y embolismo pulmonar recurrente: revisión sistemática y metaanálisis

dc.rights.licenseReconocimiento 4.0 Internacional
dc.contributor.advisorMeléndez Rhenals, Sugeich del Mar
dc.contributor.advisorBurgos Cárdenas, Álvaro Javier
dc.contributor.authorSalinas Mendoza, Sebastian
dc.date.accessioned2024-02-06T20:13:44Z
dc.date.available2024-02-06T20:13:44Z
dc.date.issued2023-09-18
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/85635
dc.descriptionilustraciones a color, diagramas
dc.description.abstractLa enfermedad tromboembólica venosa (ETV) es una afección crónica y recurrente. Si bien la anticoagulación es efectiva, conlleva un alto riesgo de complicaciones. La duración óptima de esta terapia sigue siendo desconocida. Objetivo: Evaluar el uso del D-dímero y la ecografía de miembros inferiores como estrategias pronósticas para la recurrencia de la ETV. Se realizó una búsqueda el 28 de mayo de 2022 en las bases de datos de Medline, EMBASE y Cochrane. (PROSPERO CRD42022341082) Se incluyeron estudios de cohorte, estudios de casos y controles, y ensayos clínicos. La búsqueda inicial arrojó 4027 títulos y resúmenes. Después de eliminar 705 duplicados y revisar 3262 títulos y resúmenes, finalmente se incluyeron 43 artículos que proporcionaban información sobre el D-dímero y/o la ecografía de miembros inferiores como factores pronósticos. Encontramos que la persistencia de Trombosis residual y Dimero d Anormal se asociaron con mayor riesgo de ETV recurrente (OR1.49, 95%IC 1.17 a 1.90), (OR 2.25, 95% IC 1.85 a 2.74; 6008 participantes I2= 25%, intervalos predictivos 1.36 a 3.71), respectivamente. Sin embargo no hay certeza sobre el valor pronostico y por ende de su utilidad clínica (HR : 2.63 0.94 a 7.34 I2: 86% 6 estudios ). Esta revisión sistemática informa con muy baja calidad de la evidencia de que el resultado anormal del dímero D o de la trombosis residual en la ecografía se asocia con un mayor riesgo de TVP recurrente; sin embargo, existe incertidumbre sobre su valor pronóstico y aplicación clínica. (Texto tomado de la fuente)
dc.description.abstractVenous thromboembolic disease (VTE) is a chronic and recurrent condition. While anticoagulation is effective, it carries a high risk of complications. The optimal duration of this therapy remains unknown. Objective: To evaluate the use of D-dimer and lower limb ultrasonography as prognostic strategies for VTE recurrence. A search was conducted on May 28, 2022, across the Medline, Embase, and Cochrane databases. (PROSPERO CRD42022341082) Selection Criteria: Cohort studies, case-control studies, and clinical trials were included. Studies were independently analyzed for inclusion criteria, exclusion criteria, and risk of bias. The initial search yielded 4027 titles and abstracts. After removing 705 duplicates and reviewing 3262 titles and abstracts, 43 articles were finally included, providing information on D-dimer and/or lower limb ultrasonography as prognostic factors. Lowquality evidence suggests that the persistence of residual thrombosis measured through CUS is associated with a higher risk of recurrent DVT (OR 1.49, 95% CI 1.17 to 1.90). Abnormal D-dimer levels are also associated with a higher risk of recurrence (OR 2.25, 95% CI 1.85 to 2.74; 6,008 participants, I2 = 25%, predictive intervals 1.36 to 3.71). However, there is uncertainty regarding the prognostic value and thus its clinical utility (HR: 2.63, 95% CI 0.94 to 7.34, I2: 86%, 6 studies). This systematic review informs with very low quality of the evidence that abnormal result of D-dimer or residual thrombosis in US is associated with a higher risk of recurrent DVT; however, there is uncertainty about its prognostic value and clinical application
dc.format.extent71 páginas
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.publisherUniversidad Nacional de Colombia
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.ddc610 - Medicina y salud
dc.subject.ddc610 - Medicina y salud::616 - Enfermedades
dc.titleDímero d y ultrasonografía de miembros inferiores como factores pronósticos de trombosis venosa profunda y embolismo pulmonar recurrente: revisión sistemática y metaanálisis
dc.typeTrabajo de grado - Especialidad Médica
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dc.publisher.programBogotá - Medicina - Especialidad en Medicina Interna
dc.coverage.cityBogotá, Colombia
dc.description.degreelevelEspecialidades Médicas
dc.description.degreenameEspecialista en Medicina Interna
dc.identifier.instnameUniversidad Nacional de Colombia
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourlhttps://repositorio.unal.edu.co/
dc.publisher.facultyFacultad de Medicina
dc.publisher.placeBogotá, Colombia
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotá
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.subject.decsTromboembolia - Diagnóstico por imagen
dc.subject.decsThromboembolism - Diagnostic imaging
dc.subject.decsExtremidad inferior - Fisiopatología
dc.subject.decsLower extremity - Physiopathology
dc.subject.decsUltrasonografía
dc.subject.decsUltrasonography
dc.subject.decsRevisión sistemática
dc.subject.decsSystematic review
dc.subject.proposalDimero D
dc.subject.proposalUltrasonografía de miembros inferiores
dc.subject.proposalTrombosis venosa profunda
dc.subject.proposalTromboembolismo pulmonar
dc.subject.proposalD-dimer
dc.subject.proposalLower limb ultrasonography
dc.subject.proposalDeep vein thrombosis
dc.subject.proposalPulmonary thromboembolism
dc.title.translatedD-dimer and lower limb ultrasound as prognostic factors for recurrent deep vein thrombosis and pulmonary embolism: systematic review and meta-analysis.
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.contentText
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2
dcterms.audience.professionaldevelopmentEstudiantes
dcterms.audience.professionaldevelopmentInvestigadores
dc.contributor.orcidSalinas Mendoza, Sebastian [0000-0002-7517-1643]


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