Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.200109
Jornal Vascular Brasileiro
Review Article

Avaliação do risco de sangramento na profilaxia do tromboembolismo venoso

Bleeding risk assessment for venous thromboembolism prophylaxis

Maria Chiara Chindamo; Marcos Arêas Marques

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Resumo

Resumo: O tromboembolismo venoso (TEV) é uma das principais causas preveníveis de morbimortalidade em pacientes hospitalizados, sendo a embolia pulmonar (EP) fatal possivelmente a sua primeira manifestação. Diretrizes nacionais e internacionais recomendam o uso de modelos de avaliação de risco para a prescrição de profilaxia do TEV em pacientes hospitalizados. Apesar das evidências e diretrizes de apoio, o uso da tromboprofilaxia permanece abaixo do ideal, o que pode resultar da baixa conscientização dos benefícios da profilaxia, mas também pode refletir o medo de complicações hemorrágicas, justificando a subutilização da tromboprofilaxia em todo o mundo. A avaliação do risco de sangramento é, portanto, necessária para a adequação de profilaxia e deve ser realizada de forma concomitante à avaliação do risco de trombose. O objetivo desta revisão é salientar a importância da avaliação conjunta do risco de TEV e do risco de sangramento em pacientes hospitalizados.

Palavras-chave

trombose venosa, embolia pulmonar, profilaxia, hemorragia, segurança do paciente, avaliação de risco

Abstract

Venous thromboembolism (VTE) is one of the main preventable causes of morbidity and mortality in hospitalized patients and fatal pulmonary embolism (PE) may be its first manifestation. Several national and international guidelines recommend using risk assessment models for prescription of VTE prophylaxis in hospitalized patients. Despite evidence and guidelines supporting VTE prevention, use of VTE prophylaxis in hospitalized patients remains suboptimal, which may be because of low awareness of the benefits of VTE prophylaxis, but might also reflect fear of bleeding complications in these patients, since this constitutes one of the main reasons for underutilization of thromboprophylaxis worldwide. Bleeding risk assessment is therefore necessary for adequate prophylaxis prescription and should be carried out concurrently with assessment of the risk of thrombosis. The purpose of this review is to highlight the importance of jointly assessing risk of VTE and risk of bleeding in hospitalized patients.

Keywords

venous thrombosis; pulmonary embolism; prophylaxis; hemorrhage; patient safety; risk assessment

References

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Submitted date:
06/17/2020

Accepted date:
10/13/2020

60a7eccfa953952f514c6d74 jvb Articles

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