PD49-04 PERIOPERATIVE ASPIRIN USE ASSOCIATED WITH INCREASED RISK FOR BLEEDING COMPLICATION FOLLOWING PARTIAL NEPHRECTOMY (2015)

You have accessJournal of UrologyKidney Cancer: Surgical Therapy VI1 Apr 2015PD49-04 PERIOPERATIVE ASPIRIN USE ASSOCIATED WITH INCREASED RISK FOR BLEEDING COMPLICATION FOLLOWING PARTIAL NEPHRECTOMY Timothy Ito, Robert Uzzo, Philip Abbosh, Nikhil Waingankar, Mohammed Haseebuddin, David Chen, Marc Smaldone, Richard Greenberg, Daniel Canter, Rosalia Viterbo, Alexander Kutikov, and Serge Ginzburg Timothy ItoTimothy Ito More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Philip AbboshPhilip Abbosh More articles by this author , Nikhil WaingankarNikhil Waingankar More articles by this author , Mohammed HaseebuddinMohammed Haseebuddin More articles by this author , David ChenDavid Chen More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Richard GreenbergRichard Greenberg More articles by this author , Daniel CanterDaniel Canter More articles by this author , Rosalia ViterboRosalia Viterbo More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , and Serge GinzburgSerge Ginzburg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2722AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of drug-eluting coronary stents has led to a rise in the number of surgeries performed in which patients must remain on anti-platelet (AP) therapy. The risks of partial nephrectomy (PNx) in patients on AP therapy is underreported. Here we evaluated perioperative outcomes in these patients. METHODS Data from 754 patients undergoing PNx between 2009-2014 at a single institution was reviewed from a prospectively collected database. Patients were separated into 3 groups: those on aspirin during surgery (group I, n=26), those on chronic AP therapy preoperatively who stopped >5 days prior to surgery (group II, n=156), and those not on chronic AP therapy (group III, n=572). The decision to continue aspirin during surgery for cardiac reasons was determined utilizing the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Non-cardiac Surgery. Complications within 30 days were recorded. Bleeding complications were defined as transfusion of >2U PRBC during initial hospitalization or any readmission or secondary procedure due to hemorrhage. Univariate analysis was performed using chi-square and one-way ANOVA. Multivariable analysis (MVA) was performed using logistic regression. RESULTS The primary indication for AP during PNx was a significant cardiac history (77%). Patients remaining on aspirin during surgery were older (mean 66yo vs 64yo in group II and 56yo in group III, p<0.001), more frequently male (81% vs 69% vs 61%, p=0.03), and had more comorbidities (mean ASA classification 2.68 vs 2.39 vs 2.14, p<0.001). No significant difference existed between the groups regarding nephrometry score (NS), percent undergoing minimally invasive surgery (MIS), mean operative time, EBL, ischemia time or length of initial hospital stay. Transfusion rates were higher in group I (7.7% vs 2.6% vs 2.3%) although this was not statistically significant (p=0.23). There was no difference in major complications (≥Clavien grade 3) between the groups (6.6% vs 7.7% vs 7.1%, p=0.96). Bleeding complications were significantly higher in patients on AP intraoperatively (11.5% vs 1.9% vs 3.0%, p=0.03). On MVA controlling for age, ASA classification, gender, race, MIS use, and NS, aspirin use during surgery was a significant predictor of bleeding complications (OR 5.5, 95% CI 1.3-23.3, p=0.02), but not of overall complications. CONCLUSIONS Remaining on aspirin for absolute indications during PNx is associated with a higher rate of bleeding complications but not overall complications. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e972 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Ito More articles by this author Robert Uzzo More articles by this author Philip Abbosh More articles by this author Nikhil Waingankar More articles by this author Mohammed Haseebuddin More articles by this author David Chen More articles by this author Marc Smaldone More articles by this author Richard Greenberg More articles by this author Daniel Canter More articles by this author Rosalia Viterbo More articles by this author Alexander Kutikov More articles by this author Serge Ginzburg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...