Derecho a la salud y calidad asistencial en contextos de crisis sanitaria: la trombosis venosa profunda en pacientes hospitalizados con COVID-19 en Brasil
DOI:
https://doi.org/10.54899/dcs.v23i88.4947Palavras-chave:
COVID-19, Trombosis Venosa Profunda, Derecho a la Salud, Seguridad del Paciente, Gestión HospitalariaResumo
Introducción: La pandemia de COVID-19 evidenció desafíos en la seguridad del paciente hospitalizado. Entre las complicaciones asociadas a la infección por SARS-CoV-2, la trombosis venosa profunda (TVP) destaca por su relación con el estado protrombótico de la enfermedad y por su carácter potencialmente prevenible. Desde una perspectiva jurídico-sanitaria, su ocurrencia también plantea cuestiones sobre la calidad asistencial y el cumplimiento del derecho a la salud. Objetivos: Evaluar la incidencia de TVP en pacientes hospitalizados con COVID-19 y analizar su asociación con características clínicas y desenlaces hospitalarios. Metodología: Estudio observacional analítico retrospectivo basado en la revisión de registros clínicos de pacientes adultos hospitalizados entre marzo de 2020 y octubre de 2024 en un hospital terciario de Sergipe, Brasil. De 6.281 pacientes elegibles, 5.831 fueron incluidos. Se analizaron variables sociodemográficas, comorbilidades, ingreso en UCI, ventilación mecánica, uso de dispositivos invasivos, duración de hospitalización y desenlaces. Se aplicaron análisis estadísticos descriptivos y comparativos (p < 0,05). Resultados: Se identificaron 69 casos de TVP (1,18%) y una incidencia global de tromboembolismo venoso de 2,45%. Los pacientes con TVP presentaron mayor edad, mayor prevalencia de comorbilidades y mayor gravedad clínica, con más ingresos en UCI, ventilación mecánica y uso de dispositivos invasivos. También mostraron mayor duración de hospitalización (22 vs 8 días) y mayor mortalidad (37,68% vs 11,09%; p<0,001). Discusión: La TVP se asoció con mayor gravedad clínica, mayor utilización de recursos hospitalarios y peor evolución en pacientes con COVID-19, lo que refuerza la importancia de estrategias de estratificación de riesgo y tromboprofilaxis durante la hospitalización. Conclusión: La TVP constituye una complicación prevenible de alto impacto clínico y sanitario. Desde un enfoque interdisciplinario entre medicina y derecho, su prevención y manejo oportuno son esenciales para garantizar la seguridad del paciente y el derecho a la salud en contextos de crisis sanitarias.
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