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Venous thromboembolism after radical cystectomy and urinary diversion: a single-center experience with 1737 consecutive patients.
Scand J Urol 2019; :1-6SJ

Abstract

Background:

To investigate the incidence, timing, and risk factors of venous thromboembolic events (VTE) following radical cystectomy and urinary diversion in a large cohort of patients.Patients and

Methods:

The electronic data base of patients underwent radical cystectomy and urinary diversion in a tertiary referral center between January 2004 and February 2014 was retrospectively reviewed. Patients developed VTE namely deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days after surgery were identified and compared to those without VTE. Univariate and multivariate analyses were used to evaluate the predictors of the VTE.

Results:

Out of 1737 patients, 77 VTE have occurred in 70 (4%) patients. DVT and PE occurred in 34 (2%) and 43 (2.5%) patients, respectively. PE was the leading cause of mortality in 17 patients. The median (range) time for VTE was 11 days (1-92) with 39 (50.6%) events developed after the stoppage of thrombo-prophylaxis. On multivariate analysis, older age ≥60 years (OR = 1.9; p = 0.009), female gender (OR = 1.9; p = 0.02), morbid obesity (BMI ≥35 kg/m2) (OR = 2.4; p = 0.008) and preoperative platelet count (≥300.000/cc) (OR = 1.6; p = 0.045) were significant predictors for developing VTE.

Conclusion:

The overall incidence of VTE is 4% with more than half of events occurred after the stoppage of thromboprophylaxis highlighting the necessity of adopting an extended protocol. Independent predictors included older age, female gender, morbid obesity and preoperative thrombocytosis. These group of patients require particular attention for the prevention of this complication.

Authors+Show Affiliations

Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31830847

Citation

Laymon, Mahmoud, et al. "Venous Thromboembolism After Radical Cystectomy and Urinary Diversion: a Single-center Experience With 1737 Consecutive Patients." Scandinavian Journal of Urology, 2019, pp. 1-6.
Laymon M, Harraz A, Elshal A, et al. Venous thromboembolism after radical cystectomy and urinary diversion: a single-center experience with 1737 consecutive patients. Scand J Urol. 2019.
Laymon, M., Harraz, A., Elshal, A., Shokeir, A., Elbakry, A., Abol-Enein, H., ... Mosbah, A. (2019). Venous thromboembolism after radical cystectomy and urinary diversion: a single-center experience with 1737 consecutive patients. Scandinavian Journal of Urology, pp. 1-6. doi:10.1080/21681805.2019.1698652.
Laymon M, et al. Venous Thromboembolism After Radical Cystectomy and Urinary Diversion: a Single-center Experience With 1737 Consecutive Patients. Scand J Urol. 2019 Dec 12;1-6. PubMed PMID: 31830847.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous thromboembolism after radical cystectomy and urinary diversion: a single-center experience with 1737 consecutive patients. AU - Laymon,Mahmoud, AU - Harraz,Ahmed, AU - Elshal,Ahmed, AU - Shokeir,Ahmed, AU - Elbakry,Amr, AU - Abol-Enein,Hassan, AU - Shaaban,Atallah, AU - Mosbah,Ahmed, Y1 - 2019/12/12/ PY - 2019/12/14/entrez PY - 2019/12/14/pubmed PY - 2019/12/14/medline KW - Pulmonary embolism KW - deep venous thrombosis KW - radical cystectomy KW - thrombo-prophylaxis SP - 1 EP - 6 JF - Scandinavian journal of urology JO - Scand J Urol N2 - Background: To investigate the incidence, timing, and risk factors of venous thromboembolic events (VTE) following radical cystectomy and urinary diversion in a large cohort of patients.Patients and Methods: The electronic data base of patients underwent radical cystectomy and urinary diversion in a tertiary referral center between January 2004 and February 2014 was retrospectively reviewed. Patients developed VTE namely deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days after surgery were identified and compared to those without VTE. Univariate and multivariate analyses were used to evaluate the predictors of the VTE.Results: Out of 1737 patients, 77 VTE have occurred in 70 (4%) patients. DVT and PE occurred in 34 (2%) and 43 (2.5%) patients, respectively. PE was the leading cause of mortality in 17 patients. The median (range) time for VTE was 11 days (1-92) with 39 (50.6%) events developed after the stoppage of thrombo-prophylaxis. On multivariate analysis, older age ≥60 years (OR = 1.9; p = 0.009), female gender (OR = 1.9; p = 0.02), morbid obesity (BMI ≥35 kg/m2) (OR = 2.4; p = 0.008) and preoperative platelet count (≥300.000/cc) (OR = 1.6; p = 0.045) were significant predictors for developing VTE.Conclusion: The overall incidence of VTE is 4% with more than half of events occurred after the stoppage of thromboprophylaxis highlighting the necessity of adopting an extended protocol. Independent predictors included older age, female gender, morbid obesity and preoperative thrombocytosis. These group of patients require particular attention for the prevention of this complication. SN - 2168-1813 UR - https://www.unboundmedicine.com/medline/citation/31830847/Venous_thromboembolism_after_radical_cystectomy_and_urinary_diversion:_a_single-center_experience_with_1737_consecutive_patients L2 - http://www.tandfonline.com/doi/full/10.1080/21681805.2019.1698652 DB - PRIME DP - Unbound Medicine ER -