Zheng Zhihuan, Wu Ziqiang, Li Kaixuan, Zhu Quan, Li Haozhen, Liu Xuesong, Wang Guilin, Tang Zhengyan, Wang Zhao
Xiangya Hospital, Central South University, Changsha, China.
Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha, China.
Front Surg. 2022 Feb 7;8:744244. doi: 10.3389/fsurg.2021.744244. eCollection 2021.
Venous thromboembolism (VTE) in patients following transurethral resection of the prostate (TURP) has been overlooked for many years. This research was aimed to investigate the incidence and risk factors of VTE in patients after TURP.
A total of 451 patients who underwent TURP between January 2017 and December 2020 were retrospectively analyzed. Clinical data of the patients were collected, such as basic demographic data, prostate volume, creatinine values, hemoglobin values, surgery duration, Caprini score, international prostate symptom score (IPSS), quality of life (QOL) score, plasma D-dimer levels, and so on. Univariate analysis and multivariate logistic regression were performed to identify the potential risk factors of VTE. Venous ultrasonography of lower extremities was performed routinely to detect VTE for patients after TURP.
In total, 36 (8%) out of the 451 patients suffered from VTE. A total of 12 (2.7%) patients were confirmed with deep venous thrombosis (DVT). Two patients (0.4%) were identified with pulmonary embolism (PE). Twenty-two (4.9%) patients were suffered from superficial venous thrombosis. Furthermore, according to the results of multivariate stepwise logistic regression analysis, having a history of VTE (adjusted odds ratio [aOR] = 10.980, 95% CI = 2.265-53.223), complicated with postoperative bladder hematoma (aOR = 6.302, 95% CI = 2.265-17.532), D-dimer >1.25 mg/L (aOR = 4.402, 95% CI = 1.798-10.774), and age >65 (aOR = 3.106, 95% CI = 1.084-8.893) were independent risk factors of VTE after TURP. In addition, the nomogram prediction model is a useful auxiliary prevention tool of VTE.
The incidence of VTE is severely underestimated in patients following TURP. A lot of asymptomatic VTEs have been overlooked. Early detection and diagnosis of VTE are essential. Nevertheless, further verifications based on the results of large-scaled studies are still needed.
经尿道前列腺切除术(TURP)患者的静脉血栓栓塞症(VTE)多年来一直被忽视。本研究旨在调查TURP术后患者VTE的发生率及危险因素。
回顾性分析2017年1月至2020年12月期间接受TURP的451例患者。收集患者的临床资料,如基本人口统计学数据、前列腺体积、肌酐值、血红蛋白值、手术时长、Caprini评分、国际前列腺症状评分(IPSS)、生活质量(QOL)评分、血浆D-二聚体水平等。进行单因素分析和多因素logistic回归以确定VTE的潜在危险因素。对TURP术后患者常规进行下肢静脉超声检查以检测VTE。
451例患者中共有36例(8%)发生VTE。共有12例(2.7%)患者确诊为深静脉血栓形成(DVT)。2例(0.4%)患者确诊为肺栓塞(PE)。22例(4.9%)患者发生浅静脉血栓形成。此外,根据多因素逐步logistic回归分析结果,有VTE病史(调整比值比[aOR]=10.980,95%可信区间[CI]=2.265-53.223)、合并术后膀胱血肿(aOR=6.302,95%CI=2.265-17.532)、D-二聚体>1.25mg/L(aOR=4.402,95%CI=1.798-10.774)以及年龄>65岁(aOR=3.106,95%CI=1.084-8.893)是TURP术后VTE的独立危险因素。此外,列线图预测模型是VTE的一种有用的辅助预防工具。
TURP术后患者VTE的发生率被严重低估。许多无症状的VTE被忽视。VTE的早期检测和诊断至关重要。然而,仍需要基于大规模研究结果进行进一步验证。