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Venous Thromboembolism after Urological Surgery

医学 静脉血栓栓塞 普通外科 外科 血栓形成
作者
Mark D. Tyson,Erik P. Castle,Mitchell R. Humphreys,Paul Andrews
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:192 (3): 793-797 被引量:51
标识
DOI:10.1016/j.juro.2014.02.092
摘要

No AccessJournal of UrologyAdult Urology1 Sep 2014Venous Thromboembolism after Urological Surgery Mark D. Tyson, Erik P. Castle, Mitchell R. Humphreys, and Paul E. Andrews Mark D. TysonMark D. Tyson More articles by this author , Erik P. CastleErik P. Castle More articles by this author , Mitchell R. HumphreysMitchell R. Humphreys More articles by this author , and Paul E. AndrewsPaul E. Andrews More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.092AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the rates of deep venous thromboembolism and pulmonary embolism after common urological procedures in the United States. Materials and Methods: The NSQIP database was used to identify common urological procedures performed between January 1, 2005 and December 31, 2011. A total of 82,808 patients were included in the study. Results: Overall 633 (0.76% of 82,808 subjects) deep venous thromboses occurred within 30 days of surgery in this cohort of patients treated with common urological procedures. Among procedures performed at least 500 times the rates of deep venous thrombosis were highest for cystectomy/urinary diversion (3.96% [71/1,792]), partial cystectomy (2.35% [17/722]) and open radical nephrectomy (1.67% [45/2,702]). The rates of deep venous thrombosis were lowest in patients undergoing laparoscopic colpopexy (0.00% [0/707]), placement of a female sling (0.08% [9/10,648]) and hydrocelectomy/spermatocelectomy/varicocelectomy (0.13% [3/2,333]). A total of 349 (0.42%) pulmonary embolisms occurred in this cohort, with cystectomy/urinary diversion having the highest rate overall (2.85% [51/1,792]). Multivariate logistic regression revealed that age greater than 60 years, functional status, history of disseminated cancer, congestive heart failure, anesthesia time greater than 120 minutes and chronic steroid use were independently associated with the formation of deep venous thrombosis/pulmonary embolism. A limitation of the study is that no data were available on thromboembolic prophylaxis. Conclusions: While deep venous thrombosis and pulmonary embolism are uncommon after urological surgery, this study is the first to our knowledge to provide a comprehensive comparison of deep venous thrombosis/pulmonary embolism rates across a full spectrum of various urological procedures in American patients. This study should give the reader a better understanding of the exact risk faced by the patient when undergoing common urological procedures. References 1 : Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest2004; 126: 338S. Google Scholar 2 : Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures. Thromb Haemost2003; 90: 446. Google Scholar 3 ACS NSQIP User Guide for the 2011 Participant Use Data File. Chicago: American College of SurgeonsOctober 2012. Available at http://site.acsnsqip.org/wp-content/uploads/2012/03/2011-User-Guide_Final.pdf. Accessed June 20, 2013. Google Scholar 4 : The National Surgical Quality Improvement Program in non-veterans administration hospitals: initial demonstration of feasibility. Ann Surg2002; 236: 344. Google Scholar 5 : Successful implementation of the Department of Veterans Affairs’ National Surgical Quality Improvement Program in the private sector: the Patient Safety in Surgery study. Ann Surg2008; 248: 329. Google Scholar 6 : Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg2010; 210: 6. Google Scholar 7 American College of Surgeons National Surgical Quality Improvement Program Operations Manual. Chicago: American College of Surgeons2011. Google Scholar 8 : The Patient Safety in Surgery Study: background, study design, and patient populations. J Am Coll Surg2007; 204: 1089. Google Scholar 9 : Hospital Episode Statistics data analysis of postoperative venous thromboembolus in patients undergoing urological surgery: a review of 126,891 cases. Ann R Coll Surg Engl2013; 95: 65. Google Scholar 10 : Thromboembolic events following surgery for prostate cancer. Eur Urol2013; 63: 354. Google Scholar 11 : Clinically overt venous thromboembolism after urologic cancer surgery: results from the @RISTOS Study. Eur Urol2007; 51: 130. Google Scholar 12 : Incidence, risk profile and morphological pattern of lower extremity venous thromboembolism after urological cancer surgery. J Urol2011; 186: 2293. Link, Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHebert K, Matta R, Horns J, Paudel N, Das R, Kohler T, Pastuszak A, McCormick B, Hotaling J and Myers J (2022) Risk of Postoperative Thromboembolism in Men Undergoing Urological Prosthetic Surgery: An Assessment of 21,413 MenJournal of Urology, VOL. 208, NO. 4, (878-885), Online publication date: 1-Oct-2022.Faraj K, Durant A, Mauler D, Choudry M, Singh R, Chang Y and Tyson M (2022) Extended Anticoagulation after Radical Cystectomy Using Direct Acting Oral Anticoagulants: A Single-Institutional ExperienceUrology Practice, VOL. 9, NO. 5, (451-458), Online publication date: 1-Sep-2022. Volume 192Issue 3September 2014Page: 793-797Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordspulmonary embolismvenous thrombosisurological surgical proceduresMetricsAuthor Information Mark D. Tyson More articles by this author Erik P. Castle More articles by this author Mitchell R. Humphreys More articles by this author Paul E. Andrews More articles by this author Expand All Advertisement PDF downloadLoading ...
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