RISK FACTORS FOR THE DEVELOPMENT OF COAGULOPATHY DURING SURGERY IN MECHANICAL JAUNDICE.

Abstract

Background and objectives: This prospective study was conducted at the University Hospital NAO "MUS" (Semey Medical University, Non-Profit Joint-Stock Company (NCJSC) of Semey, Kazakhstan. The objective of our investigation was to delineate potential risk factors associated with coagulopathy among patients presenting with mechanical jaundice.

Materials and methods: One hundred eighty-six patients who underwent surgical procedures between October 2020 and September 2022 in Semey, located in East Kazakhstan, were included in this study. Logistic regression analysis was employed to explore independent associations between non-coagulopathy and its respective correlates.

Results: The gender distribution among participants was as follows: 68 men (36.6%) and 118 women (63.4%), with an average age of 62.2 years (95% confidence interval: 52-72.4). Coagulopathy was observed in 87.9% of patients (N=163). Nine risk factors associated with the development of coagulopathy were included in the binary logistic regression model: nationality (p=0.005), local residence (p=0.01), obesity (p=0.0001), hemoglobin concentration (p=0.003), platelet count (p=0.008), total bilirubin level (p=0.031), alanine aminotransferase (p=0.001), soluble fibrin-monomer complexes (p=0.034), and international normalized ratio (INR) (p=0.005).

Conclusions: The majority of patients developed coagulopathy, and key sources of its occurrence were identified. Surgeons need to pay closer attention to patients of Kazakh ethnicity with obesity, as well as to those with mild anemia, elevated levels of platelet count, soluble fibrin-monomer complexes, alanine aminotransferase, and international normalized ratio, as they are more likely to develop coagulopathy. Additionally, patients with moderate or severe jaundice are also more prone to the development of coagulopathy.