Actualización de las Escalas Pronósticas para el Manejo de la Hemorragia Digestiva Alta No Varicosa

Autores/as

  • Roberto Cobiellas Rodríguez Hospital General Docente “Dr. Ernesto Guevara de la Serna”
  • Carlos E. López Milian Hospital General Docente “Dr. Ernesto Guevara de la Serna”
  • Nadieska López Morales Hospital General Docente “Dr. Ernesto Guevara de la Serna”
  • María M. Padrón Báez Hospital General Docente “Dr. Ernesto Guevara de la Serna”

Palabras clave:

Hemorragia gastrointestinal; factores de riesgo; mortalidad; endoscopía gastrointestinal; endoscopía del sistema digestivo.

Resumen

Fundamento: La existencia de un elevado número de pacientes con complicaciones debido a episodios de hemorragia digestiva alta y la posibilidad de identificarlo según una escala pronóstica. El objetivo de esta revisión fue estudiar las diversas escalas que existen para clasificar a los pacientes en grupos de riesgo alto o bajo con hemorragia digestiva alta no varicosa. Para ello se realizó una búsqueda en la base Medline entre otras de la literatura original donde se publicaron estás escalas y aquellos donde se validaron de forma actualizada, preferentemente metaanálisis y estudios aleatorios controlados. Las escalas más conocidas y validadas fueron la de Rockall y la de Glasgow-Blatchford, la primera debe emplear la panendoscopía de urgencia, lo que es una desventaja; y la segunda tiene un alto poder discriminatorio para la recurrencia de sangrado y obvia la endoscopía de urgencia. Todas las escalas clasifican a los pacientes en grupos de riesgo alto y bajo, los de alto riesgo requiere cuidados intensivos, mientras que los de riesgo bajo pueden ser dados de alta el mismo día.   Existen otras escalas más sencillas, fáciles de recordar y que obvian la realización de la endoscopía. Se concluye que todo paciente con hemorragia digestiva alta no varicosa debe ser clasificado por medio de una escala pronóstica en grupos de riesgo para su mejor evaluación, lo que permite disminuir los resultados adversos durante el episodio de sangrado.

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Publicado

2018-11-20

Cómo citar

Cobiellas Rodríguez, R., López Milian, C. E., López Morales, N., & Padrón Báez, M. M. (2018). Actualización de las Escalas Pronósticas para el Manejo de la Hemorragia Digestiva Alta No Varicosa. Revista Científica Hallazgos21, 3(3), 359–377. Recuperado a partir de https://revistas.pucese.edu.ec/hallazgos21/article/view/320

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