Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2021, Original papers
2021

Experience in a comprehensive pre-test risk assessment of thromboembolic complications in surgical patients with a high risk of congenital thrombophilia: 616.24-005.6:617.5

Original papers
Published 2021-11-30
Lyudmila Karazhanova
Semey Medical University; 103 Abay Str., Semey 071400, Kazakhstan
НАО «Медицинский Университет Семей»; Казахстан, 071400 Семей, ул. Абая, 103
Saule Isakhanova
Semey Medical University; 103 Abay Str., Semey 071400, Kazakhstan
НАО «Медицинский Университет Семей»; Казахстан, 071400 Семей, ул. Абая, 103

Keywords

venous thromboembolic complications
surgical patients
congenital thrombophilias
risk assessment
prophylaxis
  Full Text

Abstract

Summary. Background. Every year, about a third of deaths from venous thromboembolic complications (VTEC) in the world occur among surgical patients. Traditional risk assessment is not always suitable for surgical patients due to the wide disparity of age groups, the presence of patients with various thrombophilic conditions, high risks of forthcoming interventions, and low medical staff alertness. The solution is to find the best tools for pre-test diagnostics. Objectives: to analyze the results of a comprehen- sive pre-test assessment of VTEC risk in surgical patients with a high risk of congenital thrombophilia. Patients/Methods. We examined 35 patients with one of VTEC manifestations (main group) and 55 patients who had a history of VTEC or VTEC episode in first blood line relatives under the age of 50 (control group). Testing was carried out according to Geneva, Wells, and Caprini scales with subsequent analysis. Parus-test was used to detect the disturbances in protein C system. Results. The pre-test assess- ment using the Caprini scale and the normalized ratio (NR) of Parus-test showed a high risk of VTEC in patients of both groups. Conclusions. Testing with the Caprini scale and NR of Parus-test showed good results for assessment of VTEC risks and for a qual- itative selection of VTEC prevention method in surgical patients.

References:

  1. Shargall Y., Litle V.R. European perspectives in Thoracic Surgery, the ESTS venous-thromboembolism (VTE) working group. J Tho- rac Dis. 2018;10(Suppl 8): S963–S968. DOI: 10.21037/jtd.2018.04.70.
  2. Gould M.K., Garcia D.A., Wren S.M. et al. Prevention of VTE in nonorthopedic surgical patients. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. 2012;141(2 Suppl):e227S–e277S. DOI: 10.1378/chest.11–2297.
  3. ISTH Steering Committee for World Thrombosis Day. Venous thromboembolism: A call for risk assessment in all hospitalised patients. Thromb Haemost. 2016;116(Suppl 5):777–9. DOI: 10.1160/

TH16–09–0732.

4. Suleimenova R.N., Dzhanabaeva R.K., Shokhaev D. Zh., Adil- bekova Zh.K. Doppler ultrasound veins of the lower extremities in trauma patients in the postoperative period. Vestnik Kazahskogo nacional’nogo medicinskogo universiteta. 2016;(3–1):74–6. (In Russ.). 


5. Czaplicki C., Albadawi H., Partovi S. et al. Can thrombus age guide thrombolytic therapy? Cardiovasc Diagn Ther. 2017;7(Suppl 3):S186– DOI: 10.21037/cdt.2017.11.05. 


6. Linnemann B., Hart C. Laboratory diagnostics in thrombophilia. Hamostaseologie. 2019;39(1):49–61. DOI: 10.1055/s-0039–1677840. 


7. 
Begimbekova L. M., Bylantieva I. K. Risk factors of deep vein thrombosis in woman of reproductive age. Vestnik Kazahskogo nacional’nogo medicinskogo universiteta. 2015;(4):10–2. (In Russ.). 


8. Hanh B.M., Cuong L.Q., Son N.T. et al. Determination of risk fac- tors for venous thromboembolism by an adapted Caprini sco- ring system in surgical patients. J Pers Med. 2019;9(3):36. DOI: 10.3390/jpm9030036. 


9. Ruppert A., Steinle T., Lees M. Economic burden of venous throm- boembolism: a systematic review. J Med Econ. 2011;14(1):65–74. DOI: 10.3111/13696998.2010.546465. 


  1. Grosse S.D., Nelson R.E., Nyarko K.A. et al. The economic bur- den of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs. Thromb Res. 2016;137:3–10. DOI: 10.1016/j.thromres.2015.11.033. 

  2. Schulman S., Ageno W., Konstantinides S.V. Venous thromboem- bolism: Past, present and future. Thromb Haemost. 2017;117(7):1219– DOI: 10.1160/TH16–10–0823. 

  3. Stuck A.K., Spirk D., Schaudt J., Kucher N. Risk assessment mod- els for venous thromboembolism in acutely ill medical patients: A systematic review. Thromb Haemost. 2017;117(4):801–8. DOI: 10.1160/TH16–08–0631. 

  4. Pannucci C.J., Bailey S.H., Dreszer G. et al. Validation of the cap- rini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Surg. 2011;212(1):105–12. DOI: 10.1016/j.jam- collsurg.2010.08.018. 

  5. 
Pulmonary embolism. Clinical protocol for diagnosis and treat- Ministerstvo zdravoohraneniya i social’nogo razvitiya Respub- liki Kazahstan, 2016. 22 рр. (In Russ.). Available at: https:// diseases.medelement.com/disease/тромбоэмболия-легочной- артерии/14743. 

  6. Doherty S. Pulmonary embolism: An update. Aust Fam Physician. 2017;46(11):816–20.
  7. Klok F.A., Kruisman E., Spaan J. et al. Comparison of the revised Geneva score with the Wells rule for assessing clinical probabi- lity of pulmonary embolism. J Thromb Haemost. 2007;6(1):40–4. DOI: 10.1111/j.1538–7836.2007.02820.x.
  8. Shen J.H., Chen H.L., Chen J.R. et al. Comparison of the Wells score with the revised Geneva score for assessing suspected pulmo- nary embolism: a systematic review and meta-analysis. J Thromb 2016;41(3):482–92. DOI: 10.1007/s11239–015–1250–2.
  9. Barinov V.E., Lobastov K.V., Boyarintsev V.V., Schastlivtsev I.V. Clinical validation of Caprini venous thromboembolism risk assessment model in high risk surgical patients. Fundamental’nye issledovaniya. 2013;(12–1):11–6. (In Russ.).
  1. Soare A.M., Popa C. Deficiencies of proteins C, S and antithrom- bin and activated protein C resistance — their involvement in the occurrence of Arterial thromboses. J Med Life. 2010;3(4):412–5.
  2. Dahlbäck B. Activated protein C resistance and thrombosis: Mole- cular mechanisms of hypercoagulable state due to FVR506Q muta- Semin Thromb Hemost. 1999;25(3):273–89. DOI: 10.1055/ s-2007–994931.
  3. Hotoleanu C. Genetic risk factors in venous thromboembolism. Adv Exp Med Biol. 2017;906:253–72. DOI: 10.1007/5584_2016_120.
  4. Principles of prophylaxis of venous thromboembolic compli- cations in oncology. Moscow: Izdatel’stvo RAMN, 2016. 83 pp. (In Russ.).
  5. Pollak A.W., McBane R.D. Succinct review of the new VTE preven- tion and management guidelines. Mayo Clin Proc. 2014;89(3):394– DOI: 10.1016/j.mayocp.2013.11.015.
  6. ZabolotskikhI.B., Kirov M.Yu., AfonchikovV.S. et al. Periopera- tive management of patients receiving long-term antithrombotic therapy. Clinical practice recommendations of the national “Fede- ration of Anesthesiologists and Reanimatologists”. Vestnik inten- sivnoj terapii imeni A.I. Saltanova. 2021;(3):7–26. (In Russ.). DOI: 10.21320/1818–474X-2021–3–7–26.
  1. Yago H., Yamaki T., Sasaki Y. et al. Application of the Caprini risk assessment model for evaluating postoperative deep vein throm- bosis in patients undergoing plastic and reconstructive surgery. Ann Vasc Surg. 2020;65:82–9. DOI: 10.1016/j.avsg.2019.10.082.