Unified Scale for Assessing the Risk of Thromboembolic Complications – Family Doctor’s Tool for COVID-19 Pandemic
##plugins.themes.bootstrap3.article.main##
Abstract
At present one of the most discussed medical problem is a COVID-19 pandemic. The world has already registered 274 408 291 cases of infection, and 5 365 361 lethal consequences. This disease is already known for almost two years, but there are still no clear understanding of its pathophysiology, clinical course and optimal therapeutic tactics. In Ukraine during this period, 3,324,999 patients with COVID-19 were registered, 92,929 people died. It is known that in the course of the COVID-19, severe thromboeembolic complications are often observed. That is why the most important element of therapy in case of acute thromboembolic complications is the timely use of thromboprophylaxis.
The objective: is to develop an integrative scale that will summarize the conditions associated with the risk of thrombogenic complications.
Materials and methods. The literature was analyzed on the E-library, PubMed, Scopus and Web of Science Core Collection databases to study questionnaires that were previously used in the patients with a therapeutic profile. 143 patients were examined, including 119 healthy people of all ages and 24 patients with metabolic syndrome (MS) over 60 years.
General clinical, neurological, instrumental and laboratory examination were conducted.
Results. The «Unified scale for assessing the risk of thromboembolic complications» was developed, containing 17 questions and allowing to assess the presence of risk factors and the prognosis of thromboembolic complications.
The idea of creating arose on the basis of many years of experience in studying the issues of hemorheological properties of blood, microcirculation and endothelial function in persons of different ages on the basis of the Department of Clinical Physiology and Pathology of Internal Organs of the State Institution «D. F. Chebotarev Institute of Gerontology NAMS Ukraine» under the leadership of acad. NAMS of Ukraine Korkushko O.V.
The questions used in the «Thromboembolic Complications Risk Assessment Scale» are intuitive and self-explanatory. It can be used in the form of a survey with a doctor, a nurse, and also independently in the form of a patient survey. The most convenient form of use is independently in the form of a questionnaire, and the most promising is when studying the health status of individuals in large samples, for example, in communities.
The link to this questionnaire (https://forms.gle/XZwsGp5GaVuNqZeS9) was presented for the first time at the Ukrainian scientific and practical conference with international participation «Primary health care – the main component of health care in Ukraine (for the World Family Doctor Day)» of the P. L. Shupik (May 19–20, 2021).
Conclusion. Blood circulation disturbances are accompanied by considerable number of pathological conditions, where early interventions and understanding of pathological mechanisms will reduce the risk of complications and prevent fatal consequences.
The developed questionnaire allows, from the standpoint of both a doctor and a patient, to assess the risk of thromboembolic complications and identify risk factors for the development of thrombosis in routine clinical practice.
##plugins.themes.bootstrap3.article.details##
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Buryachkovskaya L. I., Lomakin N. V., Sumarokov A. B., Shirokov E. A. Algoritmy i shkaly riska tromboza i krovotecheniyav kardiologii i nevrologi Spravochnoe izdanie Prakticheskoe posobie Izdanie podgotovleno i otpechatano blagodarya sponsorskoi podderzhke OOO «Dr. Reddi’s Laboratoris». UDK 616.127-615.015-616.005.6-616-005.1 ISBN 978-5-9216-0505-3, 104 р.
Kozlov AA, Berkovsky A. L., Kachalova N. D. and others. Diagnostic kits and reagents for hemoglobinometry and the study of the hemostasis system. Collection of instructions. M., 2010. 96 p.
Korkushko O. V., Lіshnevs’ka V. Yu., Chizhova V. P., Duzhak G. V Sostoyanie mikrotsirkulyatornogo rusla u bol’nykh gipertonicheskoi bolezn’yu II st. pozhilogo vozrasta. III nats. kongres gerontologіv ta gerіatrіv Ukraini: Tezi dop.; 26-28 veresnya 2000, Kyiv. Kyiv: Іnstitut gerontologii; 2000. 80 р.
Korkushko O. V., Sarkisov K. G, Zabiyaka L. K., Lishnevskaya V. Yu., Chizhova V. P. Effect of amlodipine on the parameters of central and peripheral hemodynamics in hypertension in elderly patients. Ukrainian Journal of Cardiology. 2001; 6:43-8.
Korkushko O. V., Lishnevska V. Yu., Chizhova V. P., Duzhak G. V. Hypertensive ailments in individuals over 60 years of age and medication. Family medicine. 2004;2:44-9.
Korkushko O.V., Shatilo V.B., Lishnevskaya V.Y., Ishchuk V.А., Chizhova V.P., Duzhak G.V., Slipchenko V.V., Chizhova V.P. Change of vascular microcirculation under the influence of course of intermittent normobaric hypoxic trainings in elderly people with coronary heart disease. Circulation and haemostasis. 2006; 3:13-9.
Chizhova V.P. Peculiarities of microcirculation and function of the endothelium in subjects aged 60+ with insulin resistance. Intern. scientific – practical. conf. ACCELERATED AGING: mechanisms, diagnostics, prevention; 2012 October 4-5; Kiev. Mat. conf. Probl. aging and longevity. 2012; 21(3):375-81.
Korkushko O.V., Shatilo V.B., Chizhova V.P., Bondarenko E.V., Antonyuk-Shcheglova I.А., Naskalova S.S., Duzhak G.V., Samots I.А., Naumchuk N.S. Carbohydrate metabolism disturbances and their role in changing hemovascular hemostasis and endothelium function of the microcirculatory vessels in essentially healthy elderly people Circulation and haemostasis. 2014;1-2:5-15.
Korkushko O.V., Chizhova V.P., Antonyuk-Scheglova І.A., Shatilo V.B., Zhuravlyova J.B. The influence of disturbances of the carbohydrate metabolism and obesity upon functional state of endothelium of different caliber vessels in subjects over 50 years old Ukrainian Journal of Cardiology. 2017; 1:76-84.
Malaya L.T., Miklyaev I.Yu., Kravchun P.G. Mikrotsirkulyatsiya v kardiologii. Kh.: Vishcha shkola; 1977. 232 р.
Moskalenko VF, Gulchiy OP, Colubchikov MV. Biostatistika. Kyiv: Knigaplus; 2009. 184 p. Ukrainian.
Patent 46415A Ukraina, MPK 6 A61V 5/00, A61V 10/00. Sposіb viznachennya funktsіonal’nogo stanu endotelіyu mіkrosudin u osіb pokhilogo vіku № 2001074868; Zayavl. 11.07.2001; Opubl. 15.05.2002, Byul. № 5, 2002.
Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369–429.
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97.
Elisabeth M. Battinelli COVID-19 concerns aggregate around platelets. Blood. 2020 Sep 10; 136(11): 1221-3.
Olesen JB, Lip GY, Hansen ML, et al. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011;342:d124.
Stroke Risk in Atrial Fibrillation Working Group. Independent predictors of stroke in atrial fibrillation: a systematic review. Neurology. 2007; 69(6):546-54.