VENOUS THROMBOEMBOLIC COMPLICATIONS IN COMBAT CASUALTIES gvkg2024@mail.ru

 

VENOUS THROMBOEMBOLIC COMPLICATIONS IN COMBAT CASUALTIES

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Evgeniy Tretyakov gvkg2024@mail.ru The main military clinical hospital Russian National Guard Troops Balashicha Russia

Maksim Fedosov gvkg2024@mail.ru The main military clinical hospital Russian National Guard Troops Balashicha Russia *

Russia

Oral only

Despite the preventive measures taken, the incidence of venous thromboembolic complications (VTEC) in combat casualties reaches 28%.

Records of combat-wounded in 2020-2025 were reviewed. Depending on the severity of the injuries received, casualties were divided into 2 groups. Group I included wounded with ISS≤6, group II – with ISS˃6. For group I prophylactic anticoagulant therapy prescribed only in cases of extensive soft tissue injuries, vessel injuries with no risk of bleeding or bedridden patients. Elastic bandages, intermittent pneumocompression (IPC) were used. All wounded in group II were prescribed anticoagulant therapy in prophylactic dosages, combine with elastic bandages, IPC or electrical myostimulation (in cases of external fixation devices). Surgical prevention of VTE consisted of installing a removable vena cava filter, followed by its removal after resolution of embolic thrombosis.

A total of 1563 records were reviewed. A statistically significant relationship was revealed between the severity of the injury and the incidence of DVT: a significant increase in the number of DVTs in group II compared to group I (χ2=10.2;p<0.002). It was found that with ISS˃6, the risk of developing VTEC in group II increases by 4.5 times (95%CI:1.6–12.6;p=0.003) compared with group I. Floating thrombi were detected in 6(6.1%), PE in 3(1,25%) of group II. VTEC developed in 14(15,7%) of group II during standard pharmacoprophylaxis.

The incidence of VTEC in wartime casualties is 9,6%. Of these, VTEC develops in 2.45% with ISS≤6 and in 37% with ISS˃6. Electromyostimulation – method of choice for prevention VTEC when an external fixation device is applied.