Publication: Evaluación del pronóstico y calidad de vida en pacientes ancianos con enfermedad tromboembólica
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2019-11-11
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Universidad Complutense de Madrid
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Abstract
La enfermedad tromboembólica venosa (ETEV) incluye dos entidades íntimamente relacionadas: el tromboembolismo pulmonar (TEP) y la trombosis venosa profunda (TVP). Su prevalencia aumenta con la edad por lo que, dado el envejecimiento de la población a nivel global, un porcentaje creciente de los pacientes con ETEV son ancianos. Sin embargo, la población mayor está habitualmente infrarrepresentada en los estudios y ensayos clínicos, obligando a los clínicos a generalizar los resultados derivados de personas jóvenes a un colectivo mucho más heterogéneo y complejo. Además, los ancianos presentan ciertas características intrínsecas como son la multimorbilidad, la discapacidad y la fragilidad cuyo impacto en el pronóstico de la ETEV ha sido poco estudiado. Por otra parte, dado el panorama actual en el que se encuentra la ETEV, con el desarrollo de nuevos fármacos y pautas de tratamiento, el uso de la calidad de vida (CV) y las preferencias del paciente puede suponer una ayuda para la toma de decisiones entre el paciente y el clínico de cara a ponderar el riesgo de recurrencia, el riesgo de sangrado y la carga del tratamiento en este grupo...
Venous thromboembolism (VTE) comprises two correlated disorders: pulmonary embolism (PE) and deep vein thrombosis (DVT). Its prevalence rises in the aged so,as the global population is getting older, the elderly are becoming an increased percentage of VTE patients. However, the aged are usually underrepresented in observational studies or clinical trials, and clinicians should extrapolate evidence from a younger population to a more heterogeneous and complex group of patients. Moreover, the elderly frequently show some unique characteristics as multimorbidity, disability and frailty, and there is a lack of evidence about the impact of these features on the VTE prognosis. On the other hand, choosing the optimal therapy for every individual, with an acceptable balance between their thrombotic and bleeding risk, their comorbidity and treatment burden is a difficult task. In this setting, evaluation of the quality of life (QoL) and patient preferences can be a useful tool to trade-off all therapeutic alternatives...
Venous thromboembolism (VTE) comprises two correlated disorders: pulmonary embolism (PE) and deep vein thrombosis (DVT). Its prevalence rises in the aged so,as the global population is getting older, the elderly are becoming an increased percentage of VTE patients. However, the aged are usually underrepresented in observational studies or clinical trials, and clinicians should extrapolate evidence from a younger population to a more heterogeneous and complex group of patients. Moreover, the elderly frequently show some unique characteristics as multimorbidity, disability and frailty, and there is a lack of evidence about the impact of these features on the VTE prognosis. On the other hand, choosing the optimal therapy for every individual, with an acceptable balance between their thrombotic and bleeding risk, their comorbidity and treatment burden is a difficult task. In this setting, evaluation of the quality of life (QoL) and patient preferences can be a useful tool to trade-off all therapeutic alternatives...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 25-09-2019