Model for calculating the risk of venous thrombosis

Abstract

Aim. To develop a model for calculating the risk of venous thrombosis, taking into account the presence of known risk factors, comorbidity and congenital thrombophilia.Material and methods. During the study (2015 to 2017), 79 patients with venous thrombosis were examined (36 men and 43 women, mean age — 56,76±15,570). The control group consisted of 83 patients and healthy volunteers without thrombosis at the moment and in history (35 men and 48 women, average age — 43,95±18,136). All individuals included in the study were analyzed for the presence of G1691A mutations in the factor V gene, G20210A in the prothrombin gene, C677T polymorphism in the 5,10-methylenetetrahydrofolate reductase gene, and polymorphism in the SERPINE1 gene of plasminogen activator inhibitor. Real-time polymerase chain reaction was used to identify mutations. To create a risk calculation model, a linear regression analysis was performed.Results. We have developed a model for calculating the risk of venous thrombosis. The resulting formula showed high prognostic accuracy (the area under the ROC curve is 95,9%). For patients who do not have data on the presence of these mutations, a short version of the risk calculation model was developed (the area under the ROC curve is 94,6%).Conclusion. We have developed a risk calculation model taking into account the presence of known risk factors, congenital thrombophilia and comorbidities. Thromboprophylaxis is necessary in >0,45 individual risk, which corresponds to a high risk of developing venous thrombosis. Patients who have not previously been diagnosed with thrombophilia and are in the middle risk group for venous thrombosis, according to a short version of the model, must be screened for congenital thrombophilia to clarify the risk.

Keywords

• congenital thrombophilia
• overweight
• obesity
• venous thrombosis of the lower extremities
• pulmonary embolism
• risk calculation model