南美一家医院肺栓塞登记

P. R. G. Torres, Claudio Villaquiran Torres, C. Preciado, A. Arboleda, Javier Ivan Lasso Apraez
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摘要

肺血栓栓塞(PE)引起高发病率和死亡率。由于我国对该病的信息有限,必须经常使用来自他人的信息。这就是为什么我们对哥伦比亚一家高复杂性医院治疗的PE流行病学进行了前瞻性观察研究。对科学文献进行了搜索,发现了几项倡议,但只有两项是以前的地方倡议。通过对危险因素、临床表现、诊断过程、治疗、并发症和预后的回顾,构建了RedCap项目数据收集工具。在2017年11月至2018年期间,获得122份报告,经过审查,纳入113名患者。每3.2天诊断一次PE,这是一种主要影响60岁以上女性的病理。最常见的危险因素是癌症、活动受限和深静脉血栓(DVT)史。最常见的症状是呼吸困难、胸痛和咳嗽。三分之一的病例存在深静脉血栓,大多位于远端。本院最常用的诊断方法为文献所述的诊断方法。尽管四分之一的患者有右心室功能障碍,但死亡率仅为3.5%。根据PESI进行风险分级时,多数患者为中度风险。该评分比休克指数对死亡率高的患者有更好的分层效果。没有发现生物标志物或右心室功能障碍与死亡率之间的关系。10%的患者有发生CTEPH的高风险。我们的登记可以更深入地了解南美医院这种病理的特点。
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Pulmonary Embolism Registry of a South American Hospital
Pulmonary thromboembolism (PE) causes high morbidity and mortality. Due to limited information about the disease in our country, information from others must often be used. That is why we conducted a prospective observational study on the epidemiology of PE treated in a high complexity hospital from Colombia. A search of the scientific literature was carried out finding several initiatives and only two previous local ones. A review of the risk factors, clinical presentation, diagnostic process, treatment, complications and prognosis of the disease was used to construct the tool for data collection in the RedCap program. Between November 2017 and 2018, 122 reports were obtained and after the review, 113 patients were included. A diagnosis of PE was obtained every 3.2 days, being a pathology that mainly affects women older than 60 years. The most frequent risk factors were cancer, limitation for mobilization and history of deep vein thrombosis (DVT). The most frequent symptoms were dyspnea, chest pain and cough. DVT was present in a third of the cases, being mostly distal. The diagnostic methods most used in our hospital are those described in the literature. In spite that a quarter of the patients had dysfunction of the right ventricle, mortality was only 3.5%. When classifying the risk according to PESI, most patients had intermediate risk. This score had a better performance than the shock index for stratifying patients with a high risk of mortality. No relationship was found between biomarkers or dysfunction of the right ventricle and mortality. A 10% of patients had a high risk of developing CTEPH. Our registry allows to know in a greater depth the characteristics of this pathology in a South American Hospital.
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