RISK FACTOR STRATIFICATION FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH VARICOSE VEIN DISEASE OF THE LOWER EXTREMITIES
DOI:
https://doi.org/10.11603/2414-4533.2025.1.13308Keywords:
venous thromboembolis, varicose veins, Caprini score, risk factorsAbstract
The aim of the work: to identify the risk factors for venous thromboembolism (VTE) in patients with lower extremity varicose vein disease (LEVVD) requiring surgical treatment.
Materials and Methods. From 2019 to 2023, an open, prospective study was conducted at the clinical base of the Department of Surgery for Postgraduate Education at Ivano-Frankivsk National Medical University. The study included 430 patients with LEVVD, clinical classes C2–C6 according to CEAP, who underwent surgical treatment. The study design involved patient interviews to assess the risk of postoperative VTE using the Caprini Risk Assessment Model, with cumulative scoring based on individual risk factors.
Results. Based on VTE risk stratification, the patients were distributed as follows: 102 (23.7 %) in the low-risk group, 271 (63 %) in the moderate-risk group, 39 (9.1%) in the high-risk group, 13 (3 %) in the very high-risk group, and 5 (1.2 %) in the highest-risk group. The most frequently identified risk factors for VTE in patients with varicose vein disease included surgery duration exceeding 45 minutes in 65.1 % of patients, lower extremity edema in 40.7 %, overweight in 41.2 %, and age over 40 years in 60.8 %. The most significant risk factors identified among the study patients were a history of malignancy in 1.4 % of patients, previous superficial vein thrombosis in 4.4 %, deep vein thrombosis in 2.8 %, a family history of thrombotic events in 1.2 %, and thrombophilia in 1.2 %, as well as age over 75 years. Each of these factors contributed 3 points to the cumulative risk score and alongside planned surgical treatment and the presence of LEVVD, classified these patients as high-risk for VTE.
Conclusions. VTE risk stratification in patients with LEVVD using the Caprini Risk Assessment Model is an effective strategy for preventing postoperative complications. However, the consideration of the pathogenic and clinical features of varicose vein disease progression can improve the identification of high-risk patients and assist in developing an optimal thromboprophylaxis strategy.
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