PD36-10 VENOUS THROMBOEMBOLISM RATES FOLLOWING RADICAL CYSTECTOMY STRATIFIED BY METHOD OF PROPHYLAXIS

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2017PD36-10 VENOUS THROMBOEMBOLISM RATES FOLLOWING RADICAL CYSTECTOMY STRATIFIED BY METHOD OF PROPHYLAXIS Cory Hugen, Alexander Stern, Jie Cai, Gus Miranda, Anne Schuckman, Hooman Djaladat, and Siamak Daneshmand Cory HugenCory Hugen More articles by this author , Alexander SternAlexander Stern More articles by this author , Jie CaiJie Cai More articles by this author , Gus MirandaGus Miranda More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1559AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Venous thromboembolism (VTE), comprised of deep venous thrombosis (DVT) and pulmonary embolus (PE), remains a significant complication following radical cystectomy. Recently, utilization of prophylactic dosed post-discharge subcutaneous enoxaparin has been reported to decrease VTE rates following radical cystectomy. We compared the rates of VTE following radical cystectomy at post-operative day 90 during three separate eras where patients received either prophylaxis with warfarin (1985-2007), subcutaneous heparin (2009-2012) while hospitalized, or subcutaneous heparin followed by 30-days of subcutaneous enoxaparin (2013-2015) following discharge. METHODS We used a prospectively maintained database to identify all patients who underwent radical cystectomy for primary bladder cancer with intent to cure at our institution from 1985-2015. Rates of VTE during the three different eras of VTE prophylaxis were calculated and compared. Multivariable logistic regression modeling was used to identify independent risk factors for VTE following radical cystectomy. RESULTS 2694 patients were identified during this time period and 168 patients were excluded for missing data. A total of 4.43% (n=112, 57 DVT only) patients developed VTE. Rates of VTE were not significantly different between methods of VTE prophylaxis, (p=0.8673). Multivariable logistic regression analysis identified age (OR 1.027, 95%CI 1.003-1.051), BMI (OR 1.073, 95%CI 1.034-1.113), non-orthotopic diversion (OR 0.456, 95%CI 0.261-0.794), and hospital length-of-stay (OR 1.038, 95%CI 1.011-1.064) to be independent predictors of VTE. CONCLUSIONS VTE rates in patients treated with extended post-discharge prophylactic dosed subcutaneous enoxaparin were not significantly different than VTE rates in patients treated with warfarin or subcutaneous heparin while hospitalized at 90 days post-operatively. Age, BMI, non-orthotopic urinary diversion, and hospital length-of-stay were independent predictors for VTE in patients following radical cystectomy. These results conflict with recently published reports and highlight the need for a randomized controlled trial for VTE prophylaxis following radical cystectomy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e672 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Cory Hugen More articles by this author Alexander Stern More articles by this author Jie Cai More articles by this author Gus Miranda More articles by this author Anne Schuckman More articles by this author Hooman Djaladat More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...