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

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dc.contributor.advisorMeléndez Rhenals, Sugeich del Marspa
dc.contributor.advisorBurgos Cárdenas, Álvaro Javierspa
dc.contributor.authorSalinas Mendoza, Sebastianspa
dc.contributor.orcidSalinas Mendoza, Sebastian [0000-0002-7517-1643]spa
dc.coverage.cityBogotá, Colombiaspa
dc.date.accessioned2024-02-06T20:13:44Z
dc.date.available2024-02-06T20:13:44Z
dc.date.issued2023-09-18
dc.descriptionilustraciones a color, diagramasspa
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)spa
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 applicationeng
dc.description.degreelevelEspecialidades Médicasspa
dc.description.degreenameEspecialista en Medicina Internaspa
dc.format.extent71 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameUniversidad Nacional de Colombiaspa
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombiaspa
dc.identifier.repourlhttps://repositorio.unal.edu.co/spa
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/85635
dc.language.isospaspa
dc.publisherUniversidad Nacional de Colombiaspa
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotáspa
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.placeBogotá, Colombiaspa
dc.publisher.programBogotá - Medicina - Especialidad en Medicina Internaspa
dc.relation.referencesStevens H, Peter K, Tran H, McFadyen J. Predicting the risk of recurrent venous thromboembolism: Current challenges and future opportunities. J Clin Med. 2020;9(5).spa
dc.relation.referencesParakh RS, Sabath DE. Venous Thromboembolism: Role of the Clinical Laboratory in Diagnosis and Management. Vol. 3, The journal of applied laboratory medicine. 2019.spa
dc.relation.referencesSerhal M, Barnes GD. Venous thromboembolism: A clinician update. Vascular Medicine (United Kingdom). 2019;24(2).spa
dc.relation.referencesTuretz M, Sideris AT, Friedman OA, Triphathi N, Horowitz JM. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin Intervent Radiol. 2018;35(2).spa
dc.relation.referencesHeit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1).spa
dc.relation.referencesWinter MP, Schernthaner GH, Lang IM. Chronic complications of venous thromboembolism. Journal of Thrombosis and Haemostasis. 2017;15(8).spa
dc.relation.referencesMazzolai L, Aboyans V, Ageno W, Agnelli G, Alatri A, Bauersachs R, et al. Diagnosis and management of acute deep vein thrombosis: A joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function. Vol. 39, European Heart Journal. 2018.spa
dc.relation.referencesLang I. Chronic thromboembolic pulmonary hypertension: A distinct disease entity. Vol. 24, European Respiratory Review. 2015.spa
dc.relation.referencesMedrek S, Safdar Z. Epidemiology and Pathophysiology of Chronic Thromboembolic Pulmonary Hypertension: Risk Factors and Mechanisms. Vol. 12, Methodist DeBakey cardiovascular journal. 2016.spa
dc.relation.referencesLiederman Z, Chan N, Bhagirath V. Current challenges in diagnosis of venous thromboembolism. Vol. 9, Journal of Clinical Medicine. 2020.spa
dc.relation.referencesGrosse SD, Nelson RE, Nyarko KA, Richardson LC, Raskob GE. The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs. Vol. 137, Thrombosis Research. 2016.spa
dc.relation.referencesCross MB, Boettner F. Pathophysiology of Venous Thromboembolic Disease. Seminars in Arthroplasty JSES. 2009;20(4).spa
dc.relation.referencesPalareti G. Recurrent Venous Thromboembolism: What Is the Risk and How to Prevent It. Scientifica (Cairo). 2012;2012.spa
dc.relation.referencesKhan F, Rahman A, Carrier M, Kearon C, Weitz JI, Schulman S, et al. Long term risk of symptomatic recurrent venous thromboembolism after discontinuation of anticoagulant treatment for first unprovoked venous thromboembolism event: Systematic review and meta-analysis. The BMJ. 2019;366.spa
dc.relation.referencesFahrni J, Husmann M, Gretener SB, Keo HH. Assessing the risk of recurrent venous thromboembolism – A practical approach. Vasc Health Risk Manag. 2015;11.spa
dc.relation.referencesSteinbrecher O, Šinkovec H, Eischer L, Kyrle PA, Eichinger S. D-dimer levels over time after anticoagulation and the association with recurrent venous thromboembolism. Thromb Res. 2021;197.spa
dc.relation.referencesKearon C, Ginsberg JS, Hirsh J. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Vol. 129, Annals of Internal Medicine. 1998.spa
dc.relation.referencesTan M, Huisman M V. High percentage of non-diagnostic compression ultrasonography results and the diagnosis of ipsilateral recurrent proximal deep vein thrombosis: Reply to a rebuttal. Vol. 9, Journal of Thrombosis and Haemostasis. 2011.spa
dc.relation.referencesHamadah A, Alwasaidi T, Le Gal G, Carrier M, Wells PS, Scarvelis D, et al. Baseline imaging after therapy for unprovoked venous thromboembolism: A randomized controlled comparison of baseline imaging for diagnosis of suspected recurrence. Journal of Thrombosis and Haemostasis. 2011;9(12).spa
dc.relation.referencesNeedleman L, Cronan JJ, Lilly MP, Merli GJ, Adhikari S, Hertzberg BS, et al. Ultrasound for Lower Extremity Deep Venous Thrombosis. Circulation. 2018;137(14).spa
dc.relation.referencesSteinbrecher O, Šinkovec H, Eischer L, Kyrle PA, Eichinger S. D-dimer levels over time after anticoagulation and the association with recurrent venous thromboembolism. Thromb Res. 2021;197.spa
dc.relation.referencesPalareti G, Cosmi B, Legnani C, Tosetto A, Brusi C, Iorio A, et al. d -Dimer Testing to Determine the Duration of Anticoagulation Therapy . New England Journal of Medicine. 2006;355(17).spa
dc.relation.referencesRodger MA, Kahn SR, Wells PS, Anderson DA, Chagnon I, Le Gal G, et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008;179(5).spa
dc.relation.referencesKearon C, Spencer FA, O’Keeffe D, Parpia S, Schulman S, Baglin T, et al. D-Dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: A cohort study. Ann Intern Med. 2015;162(1).spa
dc.relation.referencesYoung L, Ockelford P, Milne D, Rolfe-Vyson V, Mckelvie S, Harper P. Post-treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality. Vol. 4, Journal of Thrombosis and Haemostasis. 2006.spa
dc.relation.referencesAn J, Sun B, Ji Y, Zhang Z, Zhai Z, Wang C. d-dimer is a predictor of clot resolution in patients with pulmonary thromboembolism: A retrospective cohort study. Clinical Respiratory Journal. 2020 Jun 1;14(6):549–56.spa
dc.relation.referencesAvnery O, Martin M, Bura-Riviere A, Barillari G, Mazzolai L, Mahé I, et al. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry. J Intern Med. 2020;287:32–41.spa
dc.relation.referencesBaglin T, Palmer CR, Luddington R, Baglin C. Unprovoked recurrent venous thrombosis: Prediction by D-dimer and clinical risk factors. Journal of Thrombosis and Haemostasis. 2008 Apr;6(4):577–82.spa
dc.relation.referencesBradbury C, Fletcher K, Sun Y, Heneghan C, Gardiner C, Roalfe A, et al. A randomised controlled trial of extended anticoagulation treatment versus standard treatment for the prevention of recurrent venous thromboembolism (VTE) and post-thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (the ExACT study). Br J Haematol. 2020 Mar 1;188(6):962–75.spa
dc.relation.referencesBrighton T, Bosco A, Robedo K, Mister R, Hague W, Kirby A, et al. PB 400 | Residual Vein Thrombus Does Not Predict for Recurrent Vein Thrombosis in the ASPIRE Study.spa
dc.relation.referencesCosmi B, Legnani C, Cini M, Guazzaloca G, Palareti G. D-dimer levels in combination with residual venous obstruction and the risk of recurrence after anticoagulation withdrawal for a first idiopathic deep vein thrombosis. Thromb Haemost. 2005 Nov;94(5):969–74.spa
dc.relation.referencesCosmi B, Legnani C, Cini M, Favaretto E, Palareti G. D-dimer and factor VIII are independent risk factors for recurrence after anticoagulation withdrawal for a first idiopathic deep vein thrombosis. Thromb Res. 2008;122(5):610–7.spa
dc.relation.referencesCosmi B, Legnani C, Tosetto A, Pengo V, Ghirarduzzi A, Testa S, et al. Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: The PROLONG II prospective study. Blood. 2010 Jan 21;115(3):481–8.spa
dc.relation.referencesCosmi B, Legnani C, Iorio A, Pengo V, Ghirarduzzi A, Testa S, et al. Residual Venous Obstruction, alone and in Combination with D-Dimer, as a Risk Factor for Recurrence after Anticoagulation Withdrawal following a First Idiopathic Deep Vein Thrombosis in the Prolong Study. European Journal of Vascular and Endovascular Surgery. 2010 Mar;39(3):356–65.spa
dc.relation.referencesCouturaud F, Sanchez O, Pernod G, Mismetti P, Jego P, Duhamel E, et al. Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism The PADIS-PE Randomized Clinical Trial. JAMA. 2015;314(1):31–40.spa
dc.relation.referencesEichinger S, Minar E, Bialonczyk C, Hirschl M, Quehenberger P, Schneider B, et al. D-Dimer Levels and Risk of Recurrent Venous Thromboembolism [Internet]. Available from: https://jamanetwork.com/spa
dc.relation.referencesEichinger S, Heinze G, Jandeck LM, Kyrle PA. Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism: The vienna prediction model. Circulation. 2010 Apr;121(14):1630–6.spa
dc.relation.referencesFranco Moreno AI, García Navarro MJ, Ortiz Sánchez J, Martín Díaz RM, Madroñal Cerezo E, De Ancos Aracil CL, et al. A risk score for prediction of recurrence in patients with unprovoked venous thromboembolism (DAMOVES). Eur J Intern Med. 2016 Apr 1;29:59–64.spa
dc.relation.referencesKearon C, Gent M, Hrish J, Weitz J, Kovacs MJ, Anderson DR, et al. A comparasion fo three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism. New England Journal of Medicine. 1999;340(12):901–7.spa
dc.relation.referencesKearon C, Spencer FA, O’Keeffe D, Parpia S, Schulman S, Baglin T, et al. D-Dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: A cohort study. Ann Intern Med. 2015 Jan 6;162(1):27–34.spa
dc.relation.referencesKearon C, Parpia S, Spencer FA, Baglin T, Stevens SM, Bauer KA, et al. D-dimer levels and recurrence in patients with unprovoked VTE and a negative qualitative D-dimer test after treatment. Thromb Res. 2016 Oct 1;146:119–25spa
dc.relation.referencesKearon C, Parpia S, Spencer FA, Schulman S, Stevens SM, Shah V, et al. Long-term risk of recurrence in patients with a first unprovoked venous thromboembolism managed according to d-dimer results; A cohort study. Journal of Thrombosis and Haemostasis. 2019 Jul 1;17(7):1144–52.spa
dc.relation.referencesKijrattanakul P, Thippayanuruksakul P, Akkawat B, Rojnuckarin P. Recurrences after stopping anticoagulant therapy inThai patients with non cancer-related venousthromboembolism. 2015.spa
dc.relation.referencesLe Gal G, Carrier M, Kovacs MJ, Betancourt MT, Kahn SR, Wells PS, et al. Residual vein obstruction as a predictor for recurrent thromboembolic events after a first unprovoked episode: Data from the REVERSE cohort study. Journal of Thrombosis and Haemostasis. 2011 Jun;9(6):1126–32spa
dc.relation.referencesMazetto BM, Orsi FL de A, Silveira SAF, Zapponi KCS, Colella MP, de Paula EV, et al. Lower Echogenicity of the Residual Venous Thrombosis at Ultrasound Examination Is Associated to Recurrent Thrombosis Events. Blood. 2014 Dec 6;124(21):4251–4251.spa
dc.relation.referencesMazetto BM, Orsi FLA, Silveira SAF, Bittar LF, Flores-Nascimento MMC, Zapponi KCS, et al. Residual Vein Thrombosis Echogenicity Is Associated to the Risk of DVT Recurrence: A Cohort Study. Clinical and Applied Thrombosis/Hemostasis. 2018 Apr 1;24(3):477–82.spa
dc.relation.referencesMrozińska S, Cieslik J, Broniatowska E, Undas A. Unfavorably altered plasma clot properties in women with a HERDOO2 score equal to or greater than 2 and prediction of recurrent venous thromboembolism. Pol Arch Intern Med. 2018;128(10):572–9.spa
dc.relation.referencesPalareti G, Cosmi B, Legnani C, Tosetto A, Brusi C, Lorio A, et al. D-Dimer Testing to Determine the Duration of Anticoagulation Therapy. New England Journal Of Medicine. 2006;355:1780–9spa
dc.relation.referencesPalareti G, Cosmi B, Legnani C, Antonucci E, De Micheli V, Ghirarduzzi A, et al. D-dimer to guide the duration of anticoagulation in patients with venous thromboembolism: A management study. Blood. 2014 Jul 10;124(2):196–203.spa
dc.relation.referencesPoli D, Antonucci E, Ciuti G, Abbate R, Prisco D. Combination of D-dimer, F1+2 and residual vein obstruction as predictors of VTE recurrence in patients with first VTE episode after OAT withdrawal [4]. Vol. 6, Journal of Thrombosis and Haemostasis. 2008. p. 708–10.spa
dc.relation.referencesPosadas-Martínez ML, Torres Gómez F, Mezzarobba D, Schutz N, Ruberto J, Dovasio F, et al. Predictores de recurrencia de enfermedad tromboembólica venosa post suspensión de anticoagulación: estudio de cohorte prospectiva. Medwave. 2021 Dec 28;21(11):e8504.spa
dc.relation.referencesPrandoni P, Anthonie ;, Lensing WA, Prins MH, Bernardi E, Marchiori A, et al. Residual Venous Thrombosis as a Predictive Factor of Recurrent Venous Thromboembolism Background: The optimum duration of anticoagulant therapy [Internet]. 2002. Available from: www.annals.orgspa
dc.relation.referencesPrandoni P, Prins MH, Lensing AWA. Residual Thrombosis on Ultrasonography to Guide the Duration of Anticoagulation in Patients With Deep Venous Thrombosis: A Randomized Trial. J Vasc Surg [Internet]. 2009 Oct;50(4):960. Available from: https://linkinghub.elsevier.com/retrieve/pii/S074152140901667Xspa
dc.relation.referencesPrandoni P, Lensing AWA, Prins MH, Pesavento R, Piccioli A, Sartori MT, et al. The impact of residual thrombosis on the long-term outcome of patients with deep venous thrombosis treated with conventional anticoagulation. Semin Thromb Hemost. 2015;41(2):133–40.spa
dc.relation.referencesPrandoni P. OC 25.4 | Residual Vein Thrombosis and Serial D-Dimer for the Long-term Management of Patients with Deep Venous Thrombosis Background: The optimal long-term strategy for preventing recurrent.spa
dc.relation.referencesRodger MA, Kahn SR, Wells PS, Anderson DA, Chagnon I, Le Gal G, et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ Canadian Medical Association Journal. 2008 Aug 26;179(5):417–26.spa
dc.relation.referencesShrivastava S, Ridker PM, Glynn RJ, Goldhaber SZ, Moll S, Bounameaux H, et al. D-dimer, factor VIII coagulant activity, low-intensity warfarin and the risk of recurrent venous thromboembolism. Journal of Thrombosis and Haemostasis. 2006;4:1208–14.spa
dc.relation.referencesSiragusa S, Malato A, Anastasio R, Cigna V, Milio G, Amato C, et al. Residual vein thrombosis to establish duration of anticoagulation after a first episode of deep vein thrombosis: the Duration of Anticoagulation based on Compression UltraSonography (DACUS) study. 2008;spa
dc.relation.referencesSteinbrecher O, Šinkovec H, Eischer L, Kyrle PA, Eichinger S. D-dimer levels over time after anticoagulation and the association with recurrent venous thromboembolism. Thromb Res. 2021 Jan 1;197:160–4.spa
dc.relation.referencesTamizifar B, Oghab P, Esfahani MA. The prediction role of D-dimer in recurrence of venous thromboembolism 1-year after anticoagulation discontinuing following idiopathic deep vein thrombosis. Journal of Research in Medical Sciences. 2014spa
dc.relation.referencesten Cate-Hoek A, Erkens P, Hamulyak K, Verhezen P, ten Cate H. Is the predictive quality of D-dimer for the recurrence of thrombosis time dependent? International Society on Thrombosis and Haemostasis. 2011;9(2):1–970.spa
dc.relation.referencesTimp JF, Braekkan SK, Lijfering WM, Van Hylckama Vlieg A, Hansen JB, Rosendaal FR, et al. Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP). PLoS Med. 2019;16(10).spa
dc.relation.referencesTritschler T, Limacher A, Méan M, Rodondi N, Aujesky D. Usefulness of D-Dimer Testing in Predicting Recurrence in Elderly Patients with Unprovoked Venous Thromboembolism. American Journal of Medicine. 2017 Oct 1;130(10):1221–4.spa
dc.relation.referencesvan Hylckama Vlieg A, Baglin CA, Luddington R, Macdonald S, Rosendaal FR, Baglin TP. The risk of a first and a recurrent venous thrombosis associated with an elevated D-dimer level and an elevated thrombin potential: Results of the THE-VTE study. Journal of Thrombosis and Haemostasis. 2015 Sep 1;13(9):1642–52spa
dc.relation.referencesVorobyeva NM, Dobrovolsky AB, Panchenko EP, Titaeva E V, Karabasheva MB, Yarovoy SY, et al. Elevated D-dimer level after 1 month anticoagulant therapy as a predictor for adverse outcomes in patients with venous thromboembolism: 10-year follow-up results [Internet]. Available from: https://academic.oup.com/eurheartj/article/40/Supplement_1/ehz746.0531/5596100spa
dc.relation.referencesYang YL, Yuan P, Wang CY, Pudasaini B, Li Y, Yu YZ, et al. Variable predictors of acute pulmonary embolism recurrence with duration of follow-up. J Thorac Dis. 2020 Mar 1;12(3):403–13.spa
dc.relation.referencesZabczyk M, Plens K, Wojtowicz W, Undas A. Prothrombotic fibrin clot phenotype is associated with recurrent pulmonary embolism after discontinuation of anticoagulant therapy. Arterioscler Thromb Vasc Biol. 2017 Feb 1;37(2):365–73.spa
dc.relation.referencesEichinger S, Hron G, Kollars M, Kyrle PA. Prediction of recurrent venous thromboembolism by endogenous thrombin potential and D-dimer. Clin Chem. 2008 Dec 1;54(12):2042–8.spa
dc.relation.referencesMronzinska S, Cieslik J, Broniatowska E, Undas A. Unfavorably altered plasma clot properties in women with a HERDOO2 score equal to or greater than 2 and prediction of recurrent venous thromboembolism. Pol Arch Intern Med. 2018;128(10):572–9.spa
dc.relation.referencesAvnery O, Martin M, Bura-Riviere A, Barillari G, Mazzolai L, Mahé I, et al. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry. J Intern Med. 2020 Jan 1;287(1):32–41.spa
dc.relation.referencesHayden JA, Côté P, Bombardier C. Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med. 2006;144(6).spa
dc.relation.referencesTosetto A, Testa S, Martinelli I, Poli D, Cosmi B, Lodigiani C, et al. External validation of the DASH prediction rule: a retrospective cohort study. Journal of Thrombosis and Haemostasis. 2017 Oct 1;15(10):1963–70.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.licenseReconocimiento 4.0 Internacionalspa
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/spa
dc.subject.ddc610 - Medicina y saludspa
dc.subject.ddc610 - Medicina y salud::616 - Enfermedadesspa
dc.subject.decsTromboembolia - Diagnóstico por imagenspa
dc.subject.decsThromboembolism - Diagnostic imagingeng
dc.subject.decsExtremidad inferior - Fisiopatologíaspa
dc.subject.decsLower extremity - Physiopathologyeng
dc.subject.decsUltrasonografíaspa
dc.subject.decsUltrasonographyeng
dc.subject.decsRevisión sistemáticaspa
dc.subject.decsSystematic revieweng
dc.subject.proposalDimero Dspa
dc.subject.proposalUltrasonografía de miembros inferioresspa
dc.subject.proposalTrombosis venosa profundaspa
dc.subject.proposalTromboembolismo pulmonarspa
dc.subject.proposalD-dimereng
dc.subject.proposalLower limb ultrasonographyeng
dc.subject.proposalDeep vein thrombosiseng
dc.subject.proposalPulmonary thromboembolismeng
dc.titleDímero d y ultrasonografía de miembros inferiores como factores pronósticos de trombosis venosa profunda y embolismo pulmonar recurrente: revisión sistemática y metaanálisisspa
dc.title.translatedD-dimer and lower limb ultrasound as prognostic factors for recurrent deep vein thrombosis and pulmonary embolism: systematic review and meta-analysis.eng
dc.typeTrabajo de grado - Especialidad Médicaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdccspa
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa
dc.type.versioninfo:eu-repo/semantics/acceptedVersionspa
dcterms.audience.professionaldevelopmentEstudiantesspa
dcterms.audience.professionaldevelopmentInvestigadoresspa
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa

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