Date and place of thesis defense:
Summary: Plućna embolija u ranom postoperativnom periodu
Prof.dr.sci. Sahib Muminagić
Discussions on Language in Bosnia-Herzegovina from 1850 to 1914
This study will present the data of the analysis of the post-operative PE at the General Surgery department, Orthopedics and Gynecology at the Cantonal Hospital Zenica. The following risk factors have been analysed: pre-operative preparation and perioperative antithromboembolic protocol. This research covers sixty patients who have been subjected to the urgent and planned surgical intervention in general anesthesia. According to the standard protocol, with all the patients we followed parameters, hemogram, liver enzimes, coagulation factors, D-dimer, gas analyses of the blood and the EKG. The patients had been divided in two groups. Group A-patients who underwent urgent surgical intervention, and group B-patients who underwent planned surgical intervention. Demographic characteristics of the target groups have had no statistically worthy differences, so that the analysis of the differences, based on the appearance of the PE is valid. In group A-patients who underwent urgent surgical intervention, there were seven cases of the PE, while in group B-patients who underwent planned surgical zahvat there were two cases of the PE. This difference in number of cases is due to a proper pre-operative preparation and risk assessment, but also to the generally more difficult clinical status of the patients who were subjected to the urgent surgical intervention. In the pre-operative stage, as statistically important predicators of the appearance of PE were obesity (p=0,003), and the fibrinogen level of (p=0,002). In the post operative stage statistically important predicators of the appearance of the PE were LDH level (p=0,002), Bilirubine level in the blood (p<0,001), GGT (p=0,005), and D-dimer (p<0,001). According to the Geneve score Tachicardia (p=0,001), Dispnea (p=0,003), Cough (p=0,001), and Oxygen saturation (p=0,003) were significant. The PE was most often registered at the General Surgery and Orthopedics departments, and more rarely at the Gynecology department, which means that the type of the surgical intervention has important influence on the PE appearance. All PE cases have been diagnosed in the course of the daily routine work, clinical, laboratory and radiological researach. In comparison to the leading world guides on the diagnosis and treatment of the PE, there is a strong ling between clinically determined diagnoses of the PE and Geneva score.