Chronic hypoxia as a factor in the development of venous thromboembolic complications in pulmonary tuberculosis
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Keywords

venous thrombosis
pulmonary tuberculosis
thromboembolism
hypoxia
hypercoagulation

Abstract

To evaluate the effect of chronic hypoxia on the incidence of venous thromboembolic complications in patients with pulmonary tuberculosis and to determine measures to prevent the development of VTEC in this category of patients. Materials and methods. Based on data from the Moscow Tuberculosis Epidemiological Monitoring System, a retrospective analysis of the treatment results of 4,609 patients with newly diagnosed or recurrent tuberculosis admitted to specialized hospitals in the period from 2020 to 2022 was carried out. The frequency of diagnosed VTEC cases recorded in medical documentation and confirmed by appropriate instrumental methods was estimated. Results. In just three years, 214 cases of VTEC were observed (4.6%, 95% CI, 4.1–5.3%), which correspond to the frequency of thrombotic events detected in cancer patients. One of the significant risk factors for the development of thrombotic complications in tuberculous patients is chronic hypoxia, which most often develops in fibrous cavernous pulmonary tuberculosis. The incidence of VTEC in such forms of pulmonary tuberculosis significantly exceeds the frequency of VTEC observed in all other forms of pulmonary lesion (RR, 9.1, 95% CI, 4.7–17.6). Conclusions. Pulmonary tuberculosis, along with severe injuries and oncological diseases, can be considered as one of the major risk factors for venous thromboembolic complications. The relative risk of developing VTEC is almost 9 times higher in patients with fibrous and fibrous-cavernous forms of pulmonary tuberculosis, in which chronic hypoxia is the trigger of procoagulant factors and conditions.

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