THE PREVALENCE OF RISK FACTORS FOR VENOUS THROMBOSIS IN SURGICAL PATIENTS WITH THROMBOTIC EPISODES IN THEIR PAST HISTORY

Abstract

Objective: to study acquired and congenital (protein C level) risk factors for development of postoperative venous thrombosis in patients having phlebothrombosis in their past history. Material and methods. The subject of the study was patients (n = 32) with surgical pathology having episodes of pulmonary embolism and/or deep vein thrombosis of the lower limbs in their anamnesis. Congenital and acquired risk factors for venous thrombosis were analyzed in all the patients. We studied the following acquired risk factors: the patients′ age, obesity, varicosity of legs, diabetes mellitus, chronic lung diseases, cancer, smoking, previous trauma and surgery, long-term immobilization and also estro- and gestagenic contraceptives in women. The level of protein C was studied as an inherited factor causing phlebothrombosis. We also included some additional criteria such as early heart failure and stroke (under 45), complications of pregnancy, central vein catheterization, liver diseases, atherosclerosis of cardiac vessels and lower limbs, arterial hypertension into the list of the important risk factors. Results. The most frequent acquired risk factors were arterial hypertension (75 % of the cases), varicose veins (63 %), obesity (56 %), atherosclerosis (44 %), and diabetes mellitus (38 %). Chronic lung and liver diseases, fractures of shin bones, smoking, early infarction and strokes, complications of pregnancy, cancer were detected in the patients less often (6-31 % of the cases). Two thirds of the patients having cases of venous thrombosis revealed the deficient level of natural anticoagulant - protein C: 44 (39; 48) %. Conclusion . The detection of the acquired risk factors and especially the determination of the protein C level in blood serum in patients preparing for surgery is sufficient to be used as screening tests to assess the risk for the development of venous thrombosis.