Valoración diagnóstica clínica y analítica de la trombosis venosa profunda de miembros inferiores
Clinical analytic diagnostic assessment of deep vein thrombosis of lower limbs
Antonio-Javier Trujillo-Santosa,**
, M.a Dolores García de Lucasa,b, Rafael Ríos-Tamayoc, Alberto Jiménez-Puented, Juan-Enrique García-Sánchezb
Autor para correspondencia
trujillo@hcs.es
Correspondencia: Dr. A.J. Trujillo-Santos. Unidad de Medicina Interna. Área de Medicina. Hospital Costa del Sol. Ctra. Nacional 340, km 187. 29600 Marbella. Málaga.
Correspondencia: Dr. A.J. Trujillo-Santos. Unidad de Medicina Interna. Área de Medicina. Hospital Costa del Sol. Ctra. Nacional 340, km 187. 29600 Marbella. Málaga.
a Unidad de Medicina Interna. Área de Medicina. Hospital Costa del Sol. Marbella. Málaga
b Servicios de Medicina Interna. Hospital Valle de los Pedroches. Pozoblanco. Córdoba
c Hematología. Hospital Valle de los Pedroches. Pozoblanco. Córdoba
d Unidad de Evaluación. Hospital Costa del Sol. Marbella. Málaga
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Área de Medicina. Hospital Costa del Sol. Marbella. Málaga" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicios de Medicina Interna. Hospital Valle de los Pedroches. Pozoblanco. Córdoba" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hematología. Hospital Valle de los Pedroches. Pozoblanco. Córdoba" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Evaluación. Hospital Costa del Sol. Marbella. Málaga" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "**" "correspondencia" => "Correspondencia: Dr. A.J. Trujillo-Santos. Unidad de Medicina Interna. Área de Medicina. Hospital Costa del Sol. Ctra. Nacional 340, km 187. 29600 Marbella. Málaga." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical analytic diagnostic assessment of deep vein thrombosis of lower limbs" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-04-14" "fechaAceptado" => "1999-09-09" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec221140" "palabras" => array:2 [ 0 => "Trombosis venosa profunda" 1 => "Dímero-D" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El diagnóstico de la trombosis venosa profunda (TVP) de miembros inferiores havariado en los últimos años. El objetivo del estudio fue analizar la capacidad diagnóstica de lacombinación de datos clínicos y epidemiológicos y valores plasmáticos de dímero-D en dichaentidad.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revisaron los datos epidemiológicos y clínicos (síntomas y signos), antecedentespersonales y familiares y valores plasmáticos o positividad del dímero-D correspondientesal momento del ingreso, en las historias clínicas de 108 pacientes a los que se realizóuna flebografía ante la sospecha de TVP de miembros inferiores.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La flebografía intravenosa fue positiva en 76 casos (70,37%). Mediante regresiónlogística se obtuvo un modelo predictivo del diagnóstico de TVP que combina datos clinicoepidemiológicosy el valor del dímero-D.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La combinación de la concentración plasmática del dímero-D y el dolor en el territoriodel sistema venoso profundo es útil como aproximación diagnóstica inicial de la TVP demiembros inferiores.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Diagnosis of deep-vein thrombosis (DVT) of lower limbs has changed in recentyears. The objective of our study was to analyze the diagnostic accuracy of a combination of clinicaland epidemiological data and the D-Dimer plasma levels in this entity.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Clinical (symptoms and signs) and epidemiological data, personal and familyhistory, and D-dimer plasma levels or positivity were reviewed, on the admittance, in 108patients to whom a phlebography was performed due to a suspected DVT.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Phlebography was positive in 76 cases (70.37%). Logistic regression analysis determineda prediction model of the diagnostic of DVI including a combination of both D-dimer plasmalevels or positivity and pain along the deep venous involved area.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Combination of D-dimer testing and pain along the distribution of the deep venousarea is useful as an initial diagnostic approach to the DVI of the lower limbs.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does this patient have deep vein thrombosis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.S. Anand" 1 => "P.S. Wells" 2 => "D. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 1 | 1 | 2 |
| 2024 Octubre | 0 | 7 | 7 |
| 2024 Septiembre | 1 | 12 | 13 |
| 2024 Agosto | 0 | 9 | 9 |
| 2024 Julio | 1 | 12 | 13 |
| 2024 Junio | 1 | 9 | 10 |
| 2024 Mayo | 3 | 14 | 17 |
| 2024 Abril | 0 | 12 | 12 |
| 2024 Marzo | 0 | 26 | 26 |
| 2024 Febrero | 0 | 6 | 6 |
| 2024 Enero | 0 | 16 | 16 |
| 2023 Diciembre | 7 | 17 | 24 |
| 2023 Noviembre | 1 | 5 | 6 |
| 2023 Octubre | 0 | 12 | 12 |
| 2023 Septiembre | 0 | 1 | 1 |
| 2023 Agosto | 1 | 2 | 3 |
| 2023 Julio | 2 | 5 | 7 |
| 2023 Junio | 0 | 3 | 3 |
| 2023 Mayo | 0 | 4 | 4 |
| 2023 Marzo | 6 | 1 | 7 |
| 2023 Febrero | 0 | 3 | 3 |
| 2022 Diciembre | 0 | 6 | 6 |
| 2022 Noviembre | 0 | 1 | 1 |
| 2022 Octubre | 0 | 3 | 3 |
| 2022 Septiembre | 1 | 5 | 6 |
| 2022 Agosto | 16 | 3 | 19 |
| 2022 Julio | 1 | 0 | 1 |
| 2022 Junio | 1 | 0 | 1 |
| 2022 Mayo | 47 | 2 | 49 |
| 2022 Abril | 0 | 6 | 6 |
| 2022 Marzo | 1 | 1 | 2 |
| 2022 Febrero | 0 | 5 | 5 |
| 2022 Enero | 0 | 5 | 5 |
| 2021 Diciembre | 0 | 7 | 7 |
| 2021 Noviembre | 1 | 0 | 1 |
| 2021 Octubre | 6 | 12 | 18 |
| 2021 Septiembre | 0 | 6 | 6 |
| 2021 Agosto | 0 | 2 | 2 |
| 2021 Julio | 12 | 2 | 14 |
| 2021 Junio | 2 | 3 | 5 |
| 2021 Abril | 3 | 0 | 3 |
| 2021 Marzo | 3 | 0 | 3 |
| 2021 Febrero | 1 | 0 | 1 |
| 2021 Enero | 1 | 0 | 1 |
| 2020 Diciembre | 2 | 1 | 3 |
| 2020 Noviembre | 1 | 0 | 1 |
| 2020 Septiembre | 0 | 1 | 1 |
| 2020 Julio | 1 | 2 | 3 |
| 2020 Junio | 0 | 3 | 3 |
| 2020 Mayo | 0 | 1 | 1 |
| 2020 Abril | 1 | 2 | 3 |
| 2020 Marzo | 0 | 3 | 3 |
| 2020 Febrero | 1 | 1 | 2 |
| 2020 Enero | 2 | 6 | 8 |
| 2019 Diciembre | 0 | 14 | 14 |
| 2019 Noviembre | 1 | 0 | 1 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 0 | 3 | 3 |
| 2019 Agosto | 0 | 1 | 1 |
| 2019 Julio | 0 | 6 | 6 |
| 2019 Junio | 0 | 3 | 3 |
| 2019 Mayo | 0 | 26 | 26 |
| 2019 Febrero | 1 | 0 | 1 |
| 2018 Diciembre | 1 | 0 | 1 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Abril | 1 | 0 | 1 |
| 2017 Octubre | 30 | 2 | 32 |
| 2017 Septiembre | 33 | 1 | 34 |
| 2017 Agosto | 38 | 4 | 42 |
| 2017 Julio | 34 | 2 | 36 |
| 2017 Junio | 36 | 5 | 41 |
| 2017 Mayo | 32 | 2 | 34 |
| 2017 Abril | 28 | 1 | 29 |
| 2017 Marzo | 37 | 21 | 58 |
| 2017 Febrero | 31 | 0 | 31 |
| 2017 Enero | 21 | 0 | 21 |
| 2016 Diciembre | 64 | 4 | 68 |
| 2016 Noviembre | 100 | 4 | 104 |
| 2016 Octubre | 115 | 4 | 119 |
| 2016 Septiembre | 29 | 4 | 33 |
| 2016 Agosto | 11 | 4 | 15 |
| 2016 Julio | 29 | 2 | 31 |
| 2016 Junio | 57 | 0 | 57 |
| 2016 Mayo | 72 | 2 | 74 |
| 2016 Abril | 60 | 0 | 60 |
| 2016 Marzo | 43 | 3 | 46 |
| 2016 Febrero | 33 | 1 | 34 |
| 2016 Enero | 31 | 0 | 31 |
| 2015 Diciembre | 22 | 0 | 22 |
| 2015 Noviembre | 41 | 0 | 41 |
| 2015 Octubre | 55 | 0 | 55 |
| 2015 Septiembre | 40 | 0 | 40 |
| 2015 Agosto | 50 | 0 | 50 |
| 2015 Julio | 46 | 0 | 46 |
| 2015 Junio | 30 | 0 | 30 |
| 2015 Mayo | 26 | 0 | 26 |
| 2015 Abril | 24 | 0 | 24 |
| 2015 Marzo | 17 | 0 | 17 |
| 2015 Febrero | 20 | 0 | 20 |
| 2015 Enero | 15 | 0 | 15 |
| 2014 Diciembre | 17 | 0 | 17 |
| 2014 Noviembre | 6 | 0 | 6 |
| 2014 Octubre | 8 | 0 | 8 |
| 2014 Septiembre | 12 | 0 | 12 |
| 2014 Agosto | 16 | 0 | 16 |
| 2014 Julio | 11 | 0 | 11 |
| 2014 Junio | 9 | 0 | 9 |
| 2014 Mayo | 12 | 0 | 12 |
| 2014 Abril | 3 | 0 | 3 |
| 2014 Marzo | 6 | 0 | 6 |
| 2014 Febrero | 4 | 0 | 4 |
| 2014 Enero | 8 | 0 | 8 |
| 2013 Diciembre | 5 | 0 | 5 |
| 2013 Noviembre | 13 | 0 | 13 |
| 2013 Octubre | 18 | 0 | 18 |
| 2013 Septiembre | 9 | 0 | 9 |
| 2013 Agosto | 15 | 0 | 15 |
| 2000 Enero | 4705 | 0 | 4705 |
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