ВИВЧЕННЯ ВПЛИВУ ВІКУ ТА ІНДЕКСУ КОМОРБІДНОСТІ НА РИЗИК ТРОМБОТИЧНИХ УСКЛАДНЕНЬ У ХВОРИХ НА РАК ЕНДОМЕТРІЯ НА ДООПЕРАЦІЙНОМУ ЕТАПІ
Authors: Kryvokulsky B. D. , Zhulkevich I. V. , Kryvokulsky D. B. , Shkrobot L. V. 
Published: September 2018

Endometrial cancer (EC) is the most common gynecological malignancy in women over 50 years of age. Age is a specific, significant predictor of the survival outcome in EC. Thrombotic complications (TC) are the other frequencies due to death in cancer patients. The problem of thrombosis is relevant and occupies a large proportion of the immediate causes of death in patients with oncological practice. Identification of risk groups, the implementation of a personalized approach to the prevention of TB is very practical in patients with EC.The aim of the study – to conduct an assessment of the Charleson Comorbidity Index and identify the link between an increased risk of thrombotic formation in patients with EС and associated pathology at the preoperative stage.Materials and Methods. The study used general clinical methods of examination: laboratory, specific for determining the state of hemostasis (D-dimer, antithrombin III, protein C, fibrinogen B, ACTH , IF, PM ), ultrasound examination (abdominal organs, small pelvis, lower vessels limbs and pelvic plexus; elastography of the vessels of the lower extremities and pelvic plexus). Histologic methods of tumor investigation – to determine the relationship between histological type, depth of invasion, degree of malignancy of the tumor. Mathematical, statistical – for analysis and generalization of data in the package "Statgraph" (v.3.0).Results and Discussion. On the basis of the obtained data and analysis of the risk factors of the occurrence of TC on the scale of Caprini, we came to the conclusion that the whole surveyed group of patients in the EC referred to the high risk of TC since they had 6 or more points. This is due to age, overweight, increased body surface area and body mass index, cancer pathology, concomitant pathology, which coincides with the data of world literature. Based on the integrated assessment of the Charleson Comorbidity Index and the assessment of the risk of developing TC on the Caprini scale, we noted that the most common risk factors for thrombosis are: abnormal fat metabolism, hypertonic disease, atherosclerosis, vascular disease. The combination of two or more risk factors for thrombosis was noted at 46.25 %. Relevant statistical discrepancies (p <0.05) in the hemostasis system in patients, depending on anthropometric indices, were confirmed by correlation bonds. We established a statistically significant (0.001 <p <0.05) positive relationship (r2> 0.17) between pelvic vein thrombosis and weight, age, BM I, Caprini scale, PPT , proper weight and PPT , PM , ACTCH Fibrinogen, D-dimer and a reliable negative (r2 <-0.17) relationship between thrombosis of the veins of the small pelvis and: the relation between the level of the MS and the level of D-dimer; PM / D-dimer; AT III / D-dimer.Conclusions. Based on the correlation data, it can be argued that the calculation of the Charleson Comorbidity Index is an important element in predicting survival rates in patients, but it does not provide an opportunity to predict the risk of thrombotic complications in patients with PE . The parallel compilation of the Charleson Comorbidity Index and the determination of the risk of developing thrombotic complications in endometrial cancer patients at the preoperative stage allows the isolation of high and high-risk groups of TU , especially in women over the age of 50 with existing comorbidity.