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En términos fisiopatológicos, en el proceso trombótico se han implicado una serie de factores, clásicamente resumidos en la tríada de Virchow: a) Estasis y alteración del flujo sanguíneo, b) Lesión del endotelio, y c) Presencia de potencialidades trombóticas.
Los factores de riesgo trombótico se agrupan, de acuerdo a consensos internacionales, en tres grandes grupos: 1) de índole general (edad, obesidad, inmovilización, antecedentes de enfermedad tromboembólica venosa, varices, trombofilias congénitas y adquiridas y otras alteraciones hemotológicas), 2) asociados a procedimientos quirúrgicos (de muy alto, alto, medio y bajo riesgo), y 3) asociados a condiciones o procesos médicos (ACV, gestación y puerperio, anticonceptivos orales, tratamiento hormonales sustitutivos, neoplasias, síndrome nefrótico y tratamientos oncológicos, infarto de miocardio, insuficiencia cardíaca y arritmias.
Se entiende como estado hipercoagulable a la presencia, de potencialidades trombóticas que activan al endotelio y a los elementos formes de la sangre, principalmente las plaquetas, que favorecen la cinética plasmática que lleva a la formación de trombina, que perturban la actividad fibrinolítica, y que producen alteraciones hemorreológicas con fenómenos de turbulencia que predisponen a la trombogénesis. Dichas potencialidades trombóticas para ser consideradas como factor de riesgo deben cumplir con los criterios de causalidad de una variable. Los factores de riesgo trombótico generalmente no son similares para cada lecho vascular, arterial o venoso, ya que cada uno de ellos tiene una expresión morfológica y funcional diferente, aunque existen factores comunes para ambos.
Translation - English INTRODUCTION
In physiopathological terms, a series of factors has been implied in the thrombotic process, and they are classically summarized in the Virchow triad: a) Stasis and blood flow change, b) Endothelium lesion, c) the presence of thrombotic potentialities. The thrombotic risk factors are grouped in, according to international consensus, three main categories: 1) of general nature (age, obesity, immobility, a history of venous thrombotic disease, varicose veins, congenital and acquired thrombophilias, and other hematological changes), 2) associated with surgical procedures (very high, high, medium and low risk), and 3) associated with medical conditions or processes (CVA, gestation and puerperium, oral contraceptives, hormone replacement therapy, neoplasia, nephritic syndrome and oncology treatments, myocardial infarction, cardiac insufficiency and arrhythmia).
A hypercoagulable state is understood as: the presence of thrombotic potentialities that activate the endothelium and formed elements of the blood, mainly platelets, that favor plasmatic kinetics that lead to thrombin formation, that disrupts the fibronolytic activity, thus producing hemoreologic changes with turbulent phenomena that predispose thrombogenesis. Those thrombotic potentialities, in order to be considered a risk factor, must reunite certain variable causal criteria. Thrombotic risk factors are not usually similar for each vascular, arterial or venous bed, because each has a different morphological and functional expression, despite the fact that they have common factors.
Spanish to English (Certification Commission for Healthcare Interpreters) English to Spanish (Certification Commission for Healthcare Interpreters) Spanish to English (ALTA Language/Qualified Medical Interpreter) English to Spanish (ALTA Language/Qualified Medical Interpreter)
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