MP2-15 IDENTIFYING INCIDENCE AND RISK FACTORS FOR VTE AMONG CYSTECTOMY PATIENTS FOR BLADDER CANCER (2014)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 2014MP2-15 IDENTIFYING INCIDENCE AND RISK FACTORS FOR VTE AMONG CYSTECTOMY PATIENTS FOR BLADDER CANCER Josip Vukina, Abram McBride, Max McKibben, Jonathan Matthews, Raj Pruthi, Eric Wallen, Michael Woods, Matthew Nielsen, and Angela Smith Josip VukinaJosip Vukina More articles by this author , Abram McBrideAbram McBride More articles by this author , Max McKibbenMax McKibben More articles by this author , Jonathan MatthewsJonathan Matthews More articles by this author , Raj PruthiRaj Pruthi More articles by this author , Eric WallenEric Wallen More articles by this author , Michael WoodsMichael Woods More articles by this author , Matthew NielsenMatthew Nielsen More articles by this author , and Angela SmithAngela Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.173AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Deep venous thrombosis (DVT) and pulmonary embolism (PE) constitute the continuum of venous thromboembolism (VTE), a potentially preventable disease that carries significant morbidity and mortality. The incidence of VTE among radical cystectomy patients for bladder cancer is among the highest of genitourinary oncology procedures, conferring a 5 times increased odds of VTE. Our objective was therefore to determine the rate of VTE among patients undergoing radical cystectomy for bladder cancer using a large national database and identify risk factors for VTE in this population. METHODS Using the American College of Surgeons- National Surgical Quality Improvement Program (NSQIP), we performed a review of patients undergoing radical cystectomy for bladder cancer from 2005-2011. ACS-NSQIP collects prospective data on 135 variables, including peri-operative data, 30-day post-operative complications and mortality on major surgical procedures at over 450 participating academic and private institutions. The overall VTE rates for all groups were calculated and predictors of VTE were identified using multivariable logistic regression models. RESULTS Of 878 total patients who underwent radical cystectomy, 50 (5.69%) experienced a VTE. The most common VTE was DVT (n=25, 50%) followed by PE (n=13, 26%) and DVT + PE (n=12, 24%). On multivariable analysis (shown below), when controlling for numerous covariates, increased operative time and history of one or more neurologic comorbidities (i.e. history of TIA, stroke, paraplegia) were associated with an increased risk of VTE (see table). CONCLUSIONS VTE risk is high among radical cystectomy patients with bladder cancer with increased risk noted in those patients with neurologic comorbidities and longer operative time. Predictor Odds Ratio 95% CI p-value ≥ 1 Neurologic Comorbidity 2.78 1.10, 7.02 0.03 Operative Time (per 60 minutes) 1.19 1.05, 1.35 0.006 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e31 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Josip Vukina More articles by this author Abram McBride More articles by this author Max McKibben More articles by this author Jonathan Matthews More articles by this author Raj Pruthi More articles by this author Eric Wallen More articles by this author Michael Woods More articles by this author Matthew Nielsen More articles by this author Angela Smith More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...