Familiarity and Self-Reported Compliance with American Urological Association Best Practice Recommendations for Use of Thromboembolic Prophylaxis among American Urological Association Members

Abstract

Although younger age and self-reported urological oncologist and/or laparoscopic/robotic specialist status correlated strongly with thromboprophylaxis use, self-reported adherence to AUA Best Practice Statement was low, even in high risk cases with clear AUA Best Practice Statement recommendations such as radical cystectomy. These data identify opportunities for quality improvement in patients undergoing major urological surgery.

Guideline of guidelines: thromboprophylaxis for urological surgery

“…A second survey that polled practising AUA members also showed low rates of thromboprophylaxis use for major pelvic urological surgery [5]. Of the respondents to this survey, only 71% would frequently or always prescribe prophylaxis, while 19% would never or infrequently prescribe prophylaxis for patients undergoing cystectomy who were at high risk of VTE; the percentages for prescribing prophylaxis decreased to 61 and 28%, respectively, for a low-risk patient.…”

“…When comparing the thromboprophylaxis guidelines a spectrum of recommendations appear (Table 3). This divergence of recommendations contributes significantly to the heterogeneity of practice among urologists [4][5][6].…”

“…The existence of substantial practice variation in the use of thromboprophylaxis in urology, both within and among countries, is therefore not surprising [4][5][6]. In this context we have summarized, taking a global perspective, the available guidelines addressing the use of thromboprophylaxis in urology.…”

Venous Thromboembolism After Major Urologic Oncology Surgery: A Focus on the Incidence and Timing of Thromboembolic Events After 27,455 Operations

“…The American Urological Association (AUA) has issued its own best practice statement regarding the use of thromboprophylaxis in patients undergoing urologic surgery 22 ; however, it makes no recommendations with respect to extended-duration prophylaxis. 23 Bergqvist et al conducted a double-blinded randomized controlled trial to assess the efficacy of extended-vs shortduration enoxaparin prophylaxis among patients undergoing open abdominal or pelvic surgeries for malignancy. The trial demonstrated benefit to extended-duration prophylaxis with respect to VTE incidence without an associated increase in hemorrhagic complications; however, patients undergoing surgery for cancers of the genitourinary tract composed <10% of the study population.…”

Prostate Cancer Risk Estimation Tool Use by Members of the American Urological Association: A Survey Based Study

“…This is lower than the rate of recently published mail surveys but congruent with the rate of recently published electronic surveys. 12,15 Electronic surveys may be a limitation to survey based studies, given the lower response rate. The response rate of future survey based studies may improve with electronic and mail correspondence.…”