PREDICTION OF DEVELOPMENT OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN COMBAT BURN INJURY gvkg2024@mail.ru

 

PREDICTION OF DEVELOPMENT OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN COMBAT BURN INJURY

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

Aleksandr Kovalev gvkg2024@mail.ru The main military clinical hospital Russian National Guard Troops; Medical Institute of Continuing Education "ROSBIOTECH" Balashicha Russia

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

Russia

Oral only

Prevention of venous thromboembolic complications (VTEC) allows to save lives and reduce the duration of treatment of the wounded.

The analysis of the treatment results of 55 combat casualties with burns (2022-2025) was carried out. The average ISS was 13.1±1.5. Depending on the injury severity casualties were divided into two groups. Group I included 24 (43.6%) with ISS≤6, group II 30 (52.4%) with ISS>6. In group I pharmacoprophylaxis of VTEC was given only in 2 cases; mechanical types of prophylaxis weren't used. In group II anticoagulant therapy in prophylactic and therapeutic doses was prescribed, as well as mechanical prophylaxis in the absence of contraindications. To identify statistically significant prognostic signs of VTEC development, multiple regression analysis and ROC analysis were used.

Combined thermomechanical injuries were diagnosed in 30 (54.6%), isolated burn injury - in 25 (45.4%). Deep burns were in 23 (41.8%): 6 (26.1%) in group I, 17 (73.9%) in group II (p<0.001), thermal inhalation injury - in 11 (36.7%) of group II. In group I VTEC did not develop, in group II VTEC was noted in 40% (χ2=9.75; p<0.001), pulmonary embolism developed in 2 (3.6%). Multiple regression analysis showed that the ISS scale turned out to be a reliable prognostic indicator of the VTEC development (p=0.00007). The area under the ROC curve was 0.836.

The frequency of VTEC in combat casualties with burn injury is 21,8%, pulmonary embolism - 3.6%. The number of ISS points is a reliable prognostic sign of the development of VTEC (p=0.00007).