Assessment of the Risk of Venous Thromboembolic Complications in Urgent Abdominal Surgery in Patients With Coronavirus Disease

Introduction. Postoperative venous thromboembolic complications of the lower extremities are the most dramatic complication of urgent abdominal surgery, which significantly worsens treatment outcomes in patients with COVID-19. The purpose of the work is to analyze the risks of thromboembolic complications in operated patients with urgent surgical abdominal pathology and COVID-19 and to develop a method of predicting the risk of venous thrombosis to improve the effectiveness of prevention. Materials and methods of research. The research plan covered 524 medical records of inpatients operated on for urgent surgical abdominal pathology, some of which were diagnosed with COVID-19. Submassive thromboembolism of the pulmonary artery occurred in 57 (10.5%) operated patients on (7.8±3.4) days. Acute sudden cardiopulmonary insufficiency caused the death of 9 (52.9%) operated patients. In 4 (23.5%) patients, thromboembolism of the pulmonary artery, as the cause of death, was ascertained only during the autopsy. Thrombosis of deep veins of various locations occurred in 19.4% of operated patients with urgent abdominal pathology and COVID-19 on average (6.1±2.3) days after the intervention, of which 39.4% had an asymptomatic thrombosis. Results and their discussion. Using the multiple regression method, 57 risk factors for deep vein thrombosis of the lower extremities were evaluated and analyzed. 12 significantly reliable risk factors for venous thromboembolism in urgent abdominal surgery in patients with COVID-19 were identified and the point value of each of them was evaluated. The frequency of lower extremity vein thrombosis at low, medium, and high risk levels was 2%, 25%, and 75%, respectively. Conclusions. Venous thrombotic complications in the postoperative period occur in 19.4% of patients with acute surgical diseases of the abdominal cavity and COVID-19. The objective assessment of the risk of venous thromboembolism should be based on taking into account the point value of prognostic factors. The frequency of thrombosis of the lower veins at low, medium and high degrees of risk is 2%, 25% and 75%, respectively.