Skeletal polytrauma: prognostication and prophylaxis of embolic complications

Abstract

Objective. Improvement of the treatment results in injured persons with skeletal polytrauma. Materials and methods. In the investigation 240 patients, suffering skeletal polytrauma, took part. In the Admittance-Diagnostic Department and the Department of Intensive Therapy various scales of assessment were used for objectivisation of its state of severity in the injured persons. Results. The main risk factors for the venous thromboembolism were established in accordance to results of the investigation conducted: skeletal trauma (sensitivity 85%), durable bed-rest regime (sensitivity 94%), untimely surgical osteosynthesis (sensitivity 96%), severity of state – assessment in accordance to shortened scale of damages of 3 points and higher, in accordance to the injury severity scale of 16 points and higher (sensitivity 88%), non-compliance for the pharmacological thrombo-prophylactic regime (sensitivity 94%). Conclusion. Basing on the results obtained, a clinical route of the medical help delivery for patients, suffering skeletal polytrauma, was introduced into the practice, what have permitted to lower the rate of venous thromboembolism from 25.8 to 15% (χ2 =13.07, p=0.001), and the rate of the fat embolism syndrome - from 19.2 t0 3.3% (χ2 =15.07, p=0.001).