Predicción PERC y dimero D en el diagnóstico de embolia pulmonar aguda
Artículo revisado por pares
Enviado: 05-05-2023
Revisado: 29-05-2023
Aceptado: 20-07-2023
Publicado: 21-07-2023
Editor: Dr. William Castillo González, https://orcid.org/0000-0003-3007-920X
DOI:
https://doi.org/10.56294/saludcyt2023484Palabras clave:
Embolia pulmonar, Regla PERC, dímero-D, diagnóstico, factores de riesgo, biomarcadoresResumen
Introducción: La tromboembolia pulmonar aguda (TEPA) representa una amenaza letal que demanda detección y atención inmediata. La normativa de exclusión de embolia pulmonar (PERC, por sus siglas en inglés) junto con el dímero-D se perfilan como instrumentos eficaces para su identificación. Propósito: Nuestro análisis se enfoca en explorar los estudios existentes sobre la eficiencia del método PERC y el dímero-D para diagnosticar la tromboembolia pulmonar aguda y establecer si su aplicación conjunta incrementa la precisión diagnóstica y la categorización del riesgo en individuos bajo la sospecha de TEPA. Procedimiento: Se llevó a cabo una exploración intensiva en fuentes de información médica, como PubMed, EMBASE y Cochrane Library, con el fin de hallar investigaciones pertinentes que evalúen el método PERC y el dímero-D en la identificación de la TEPA. Hallazgos: Se incluyeron 35 estudios en la revisión literaria. La mayoría demostraron que el método PERC y el dímero-D son instrumentos valiosos para identificar la TEPA, con sensibilidad elevada y ratio de exclusión negativa. El enfoque PERC resulta particularmente útil en individuos con bajo riesgo clínico, mientras que el dímero-D resulta más eficaz en combinación con puntuaciones de probabilidad clínica. El uso conjunto de ambos puede incrementar la especificidad y optimizar la toma de decisiones clínicas. Conclusión: La revisión literaria respalda que el método PERC y el dímero-D pueden incrementar la precisión diagnóstica y la categorización del riesgo, permitiendo una toma de decisiones clínicas más eficaz y evitando pruebas de imagen adicionales en individuos con bajo riesgo de TEPA. Es necesario realizar más investigaciones para perfeccionar aún más la ejecución de estas herramientas en la práctica médica y en grupos específicos de población.
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Derechos de autor 2023 Marlon Andrés López García, Juan Andrés Barriga Miño, María Belén Medina Rodríguez, Josselin Karina Paredes Acosta, Estefania Abigail Benavides Tutillo, Yessenia del Cisne Gaona Bermeo
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