Risk of postoperative venous thromboembolic complication development in elderly patients

Abstract

Aim. To evaluate venous thromboembolic complication risk in elderly patients admitted to trauma and orthopedics departments, prevalence of comorbidity, its impact on the risk of thrombotic events, efficacy and safety of prophylactic anticoagulant therapy. Materials and methods. Authors performed a retrospective analysis of medical records of 120 patients aged 65 years and over. Analyzed data included demographic data, main diagnosis, co-existing pathology according to International Classification of Diseases X, type of surgery and anticoagulant prophylaxis. Risk of development of venous thromboembolic complications was assessed by the Caprini scale. Potential drug-drug interactions were checked using Drug Interaction Checker available, created by company Cerner Multum according to FDA recommendations. Results. The most frequent causes of hospitalization were destructive large joint arthritis (40%) and fractures of lower extremities (21.7%). Surgeries with an average duration of 87 ± 31.4 min were performed in 85% of patients, of which major surgery – 68.6%, minor – 31.4%. Comorbidity was detected in 90% of elderly patients admitted to hospital because of pathology of the musculoskeletal system. Pathology of musculoskeletal system most often was combined with cardiovascular diseases (81.7%). A moderate risk of venous thromboembolic complications was detected in 10% patients, high risk in 75%. Anticoagulant prophylaxis with a direct factor Xa inhibitor rivaroxaban or low-molecular weight heparin enoxaparine sodium was performed in 80% of patients. Conclusion. The study demonstrated that 75% of elderly patients with pathology of the musculoskeletal system are at high risk for the development of venous thromboembolic complications. The main risk factors include the type and duration of surgery and comorbidity.