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Úlceras por calcifilaxis: ¿Cuidados paliativos o desbridamiento?

Authors: Begoña Fornes-Pujalte; María Isabel Pastor-Orduña; Paula Díez-Fornes; Concepción Sierra-Talamantes; David Palomar-Albert; Jorge Zamora-Ortiz; Federico Palomar-Llatas;

Úlceras por calcifilaxis: ¿Cuidados paliativos o desbridamiento?

Abstract

Objetivo: Analizar la epidemiología y cuidados de los pacientes con diagnóstico de calcifilaxis tratados en el Servicio de Dermatología y la Unidad de Úlce-ras del Consorcio Hospital General Universitario de Valencia (CHGUV). Material y método: Estudio observacional descriptivo retrospectivo de casos clínicos de calcifilaxia vistos en el Servicio de Dermatología y la Unidad de Úlceras del CHGUV en el periodo comprendido entre los años 1997 a 2016. Variables principales: factores de riesgo, supervivencia, mortalidad y causas, tratamientos. Estadística descriptiva. Resultados: Se identificaron 11 pacientes, todos del sexo femenino. El 63% de los pacientes estaban en tratamiento en hemodiálisis. Se observó un 81% de mortalidad. La causa prevalente fue: un 9,1% se debió a sepsis y un 54,5% a shock cardíaco. Conclusiones: consideramos que sería conveniente aplicar un enfoque sistemático respecto al tratamiento de las úlceras en pacientes con calcifilaxis, adoptando en ocasiones una visión paliativa, valorando el desbridamiento en cada caso según la evaluación de las comorbilidades, la perfusión vascular y la presencia de infección.

Objective: To analyze the epidemiology and care of patients diagnosed with calciphylaxis treated in the Dermatology Service and the Ulcers Unit of the University General Hospital of Valencia Consortium (CHGUV). Material and method: Retrospective descriptive observational study of clinical cases of calciphylaxis seen in the Dermatology Department and the Ulcers Unit of the CHGUV in the period from 1997 to 2016. Main variables: risk factors, survival, mortality and causes, treatments. Descriptive statistics. Results: Eleven patients were identified, all of them female. 63% of the patients were under treatment in hemodialysis. An 81% mortality was observed. The prevalent cause was: 9.1% was due to sepsis and 54.5% to cardiac shock. Conclusions: we consider that it would be appropriate to apply a systematic approach to the treatment of ulcers in patients with calciphylaxis, adopting at times a palliative view, assessing debridement in each case according to the evaluation of comorbidities, vascular perfusion and the presence of infection.

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Country
Spain
Keywords

Calcifilaxis, Debridement, 32 Ciencias Médicas, Calciphylaxis, Calcific uremic artery disease, Palliative care, Desbridamiento, Cuidados paliativos

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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