Ruiz-Ruiz F, Medrano F J, Santos-Lozano J M, Rodríguez-Torres P, Navarro-Puerto A, Calderón E J
Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla y Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Sevilla, España; Departamento de Medicina, Universidad de Sevilla, Sevilla, España.
Rev Clin Esp (Barc). 2019 Jan-Feb;219(1):34-43. doi: 10.1016/j.rce.2018.04.007. Epub 2018 Jun 19.
There is scarce available information on the treatment or prophylaxis with anticoagulant drugs of outpatients with medical diseases and complex clinical conditions. There are no clinical practice guidelines and/or specific recommendations for this patient subgroup, which are frequently treated by internists. Complex clinical conditions are those in which, due to comorbidity, age, vital prognosis or multiple treatment with drugs, a clinical situation arises of disease-disease, disease-drug or drug-drug interactions that is not included within the scenarios that commonly generate the scientific evidence. The objective of this narrative review is collecting and adapting of the clinical guidelines recommendations and systematic reviews to complex clinical conditions, in which the direct application of recommendations based on studies that do not include patients with this complexity and comorbidity could be problematic.
关于患有内科疾病和复杂临床状况的门诊患者使用抗凝药物进行治疗或预防的可用信息很少。对于这一常由内科医生治疗的患者亚组，没有临床实践指南和/或具体建议。复杂临床状况是指由于合并症、年龄、重要预后或多种药物治疗，出现了疾病-疾病、疾病-药物或药物-药物相互作用的临床情况，而这些情况并不在通常产生科学证据的情形范围内。本叙述性综述的目的是收集临床指南建议和系统评价，并使其适用于复杂临床状况，在这种情况下，直接应用基于未纳入具有这种复杂性和合并症患者的研究得出的建议可能会有问题。
