Venous Thromboembolism Following Radical Cystectomy: Significant Predictors, Comparison of Different Anticoagulants and Timing of Events

Sun, Andrew; Djaladat, Hooman; Schuckman, Anne; Miranda, Gus; Cai, Jie; Daneshmand, Siamak

doi:10.1016/j.juro.2014.08.085

Cited by 57 publications

(37 citation statements)

References 31 publications

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“…An incidence of 1.8% recorded in this study is comparable with other contemporary series which report VTE rates varied between 0.4 and 5.5% in major urologic oncology surgery [2-5]. We also found that radical cystectomy confers a greater risk of VTE compared to radical cystectomy, again in keeping with published data [6][7][8][9][10][11][12][13]. The probable reason for this is the fact that patients undergoing radical cystectomy have greater risk factors for VTE compared to those undergoing radical prostatectomy.…”

Section: Discussionsupporting

confidence: 91%

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

et al. 2015

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ObjectiveTo determine the incidence and assess risk factors for the development of VTE among patients undergoing major pelvic surgery for prostate and bladder cancer in an Australian tertiary referral center. Patients and MethodsConsecutive patients undergoing major pelvic uro-oncologic surgery, namely radical cystectomy and radical prostatectomy over a five-year period (2009-2013) were identified. Patient variables and types of thromboprophylaxis (pharmacological and/or mechanical) used in this patient cohort were collected for analyses as predictive factors. ResultsThe overall incidence of VTE was 1.8%. Patients undergoing radical cystectomy were more likely to suffer a VTE event compared to patients having radical prostatectomy. In this cohort, the risk factors for VTE include, prolonged operative time of greater than 4 hours (h), lymph node dissection (LND) and patients requiring blood transfusions. ConclusionPatients undergoing major pelvic uro-oncologic surgery have an approximately 1.8% risk of developing VTE. Risk factors identified in this study should be used to guide the use of early and prolonged thromboprophylaxis.

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Section: Discussionsupporting

confidence: 91%

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

et al. 2015

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“…Predictors of high risk for VTE development identified include: elevated BMI, surgical margins, type of diversion and length of hospital stay. 48 Alberts et al reported a similar rate, 5.5%, among 2065 patients within 30 days of surgery. This group noted lower rates in patients undergoing radical/partial nephrectomy (0.7%) and radical prostatectomy (1.3%).…”

Section: Anticoagulation During Open Surgery and Reconstructive Urolomentioning

confidence: 81%

Haematological considerations in urology: A systematic review

Abusanad

Floyd

Johnson

et al. 2015

Journal of Clinical Urology

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Deep venous thrombosis (DVT) remains a serious and common complication of surgical procedures and is therefore an issue of importance for all urologists. In the UK, pulmonary embolism (PE) following DVT in hospitalised patients causes 32,000 deaths each year. DVT and PE represent the outcome of venous thromboembolism (VTE). The total cost for management of VTE in 2005 was approximately ₤640 million. Early risk assessment and optimising modifiable risks are paramount in order to reduce the incidence of VTE. In this article we review common risk factors for VTE and emphasise specific risk factors for urological procedures. The perioperative management of urological patients who are chronically anticoagulated is discussed. We review the literature regarding anticoagulation and its relevance to all urological procedures and mention the problems associated with new anticoagulant agents. All urologists should be familiar with the new range of anticoagulant agents due to the increasing number of patients taking them.

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“…Twelve studies investigated the association between BMI and RC outcomes [33][34][35][36][37][38][39][40][41][42][43][44] . Reyes et al 33 found that tract infections, pyelonephritis, wound infections and overall complications were less frequent in normal-weight patients (18.5-24.9kg/m 2 ) compared to overweight (25-29.9kg/m 2 ) and obese (≥30.0kg/m 2 ) patients.…”

Section: Body Mass Indexmentioning

confidence: 99%

“…BMI was not a predictor of mortality and complication development after RC in the Maurer et al 35 study, except for postoperative bleeding, which was more frequent in subjects with a high BMI. Compared to subjects with a BMI of 18-25kg/m 2 , subjects with a BMI >30kg/m 2 had a higher risk of cancer-specific mortality 38,42 , incisional hernia 40 , re-admission 30d and 90d after RC 39 , ileus 36 , parastomal hernia 45 and deep venous thrombosis 43,44 .…”

Section: Body Mass Indexmentioning

confidence: 99%

Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review

Allaire

Ben-Zvi

Lamarche

et al. 2017

CUAJ

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Only a few nutritional factors have been identified to predict the risk of developing complications after radical cystectomy (RC). This narrative review delineates the current known effects of preoperative nutritional status factors in this context. The report highlighted the heterogeneity between study methods and results. We determined that low albuminemia values increase mortality risk and overall complications. In addition, obesity tends to increase the risk of developing venous thromboembolism and adverse events. Additional prospective studies, using standardized methods to both define and report complications, should be conducted to strengthen the connections between preoperative nutritional status factors and post-RC complications. Furthermore, intervention studies testing the impact of strategies to improve nutritional status on the risk of complications after RC are also needed.

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Venous Thromboembolism Following Radical Cystectomy: Significant Predictors, Comparison of Different Anticoagulants and Timing of Events

Cited by 57 publications

References 31 publications

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

Haematological considerations in urology: A systematic review

Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review

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