Seliuk O. Comorbidity in patients with hypertension of combatants: clinical and epidemiological features, scoring of professional longevity.

Seliuk O.V. Comorbidity in patients with hypertension of combatants: clinical and epidemiological features, scoring of professional longevity. – Qualifying scientific work on the rights of the manuscript. Dissertation for the degree of Doctor of Philosophy in the field of knowledge 22 “Health” in specialty 222 “Medicine” (specialty “Internal Medicine”) – Ukrainian Military Medical Academy of the Ministry of Defense of Ukraine, Kyiv, 2023. The scientific work is devoted to the solution of the urgent military-medical task - optimization of forecasting and prolongation of fitness for military service on the state of health of patients with arterial hypertension (AH) of servicemen - participants of anti-terrorist operation / Joint Forces operation (ATO/JFO) on the basis of comprehensive analysis of new scientific data on the prevalence and course of comorbid pathology, features of treatment of hypertension taking into account comorbid pathology and by applying scoring models by the method of construction and analysis of artificial neural networks (multilayer perceptron). The reports (form 2 / med) for 2020 on morbidity indicators by disease classes and separately by disease class of the circulatory system (DCS) of servicemen of the Armed Forces of Ukraine under contract have been studied. The shares (relative frequency) of morbidity indicators by disease classes in the structure of total morbidity (for all disease classes) and the shares of these indicators by individual blocks within the DCS class were calculated. The medical records of inpatients of 213 servicemen – participants of ATO/JFO of men, aged 27-59 years, mean age 45.0 ± 6.8 years, who underwent inpatient treatment during 2018-2021 and were diagnosed with essencial hypertension I and II stage, were analyzed by random sampling. All studied patients were gradually stratified in the study by 3 groups of traits (variables): the stage of hypertension, the presence of coronary heart disease (CHD), that’s maens comorbidity, and the receipt of closed craniocerebral trauma during hostilities. For a comprehensive quantitative assessment of comorbidity, a cumulative illness rating scale CIRS was used, which provides a separate summary assessment of the state of each of the organ systems. Statistical processing of the obtained data was performed using parametric and non-parametric statistical methods and artificial intelligence methods by constructing and analyzing artificial neural networks (multilayer perceptron) using standard statistical packages STATISTICA 10.0 (USA) and IBM SPSS Statistics 23.0 (USA). The scientific novelty of the obtained results is that for the first time, using scoring models by artificial neural networks (multilayer perceptron), the model is scientifically substantiated and prognostic factors of forecasting and prolonging professional longevity of servicemen – participants of ATO/JFO, especially patients with hypertension, prevalence and course of comorbid pathology and treatment. Generated by standard statistical packages STATISTICA 10.0 and IBM SPSS Statistics 23.0, artificial neural networks have high sensitivity indicators, specificity and accuracy (87.0% – 91.8% of the correct classifications, the area under the ROC curve AUC 0.971-0.992).