Department of Urology, University of California San Francisco, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA.
Department of Epidemiology and Biostatistics, University of California San Francisco, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA.
World J Urol. 2022 Jul;40(7):1879-1886. doi: 10.1007/s00345-022-04004-4. Epub 2022 Apr 26.
To evaluate the rate of perioperative venous thromboembolism (VTE) among patients undergoing common benign urologic reconstructive cases. We hypothesize that this rate will be lower than previously described.
We utilized the American College of Surgeons National Surgical Quality Improvement Project database from 2015 to 2019 to evaluate 30-day perioperative risk of VTE. Patients ≥ 18 years old undergoing benign urologic reconstructive cases were selected using Current Procedural Terminology (CPT) codes. Demographic, comorbidity, and operative variables were captured. The primary outcome was VTE within the 30-day postoperative period.
We identified 8467 patients who met inclusion criteria. The majority of patients were male (> 95%) with an average age of 65 and BMI of 29.6. There were 23 VTE events (0.27%) within the 30-day perioperative period. Fourteen (14/59) procedures had a perioperative VTE. Many of the traditional factors for VTE including operative time and obesity significantly increased risk of VTE in univariate analysis. In multivariate analysis, only BMI (OR 1.09; 95% CI 1.01-1.12) and inpatient status (OR 4.42; 95% CI 1.9-10.2) were correlated with increased perioperative VTE.
The rate of VTE among patients undergoing benign urologic reconstructive cases is low. Providers should continue to have high index of suspicion particularly for inpatients with high BMI in addition to other known risk factors for VTE.
评估行常见良性泌尿科重建术患者的围手术期静脉血栓栓塞症(VTE)发生率。我们假设该发生率将低于先前描述的发生率。
我们利用美国外科医师学会国家手术质量改进计划数据库,从 2015 年至 2019 年评估了 30 天围手术期 VTE 的风险。使用当前操作术语(CPT)代码选择年龄≥18 岁的良性泌尿科重建患者。记录人口统计学、合并症和手术变量。主要结局是术后 30 天内发生 VTE。
我们确定了 8467 名符合纳入标准的患者。大多数患者为男性(>95%),平均年龄为 65 岁,BMI 为 29.6。在 30 天围手术期内发生了 23 例 VTE 事件(0.27%)。有 14 例(59 例中的 14 例)手术发生围手术期 VTE。许多传统的 VTE 危险因素,包括手术时间和肥胖,在单因素分析中显著增加了 VTE 的风险。在多因素分析中,只有 BMI(OR 1.09;95%CI 1.01-1.12)和住院状态(OR 4.42;95%CI 1.9-10.2)与围手术期 VTE 增加相关。
行良性泌尿科重建术患者的 VTE 发生率较低。除了其他已知的 VTE 危险因素外,提供者应继续对 BMI 较高的住院患者保持高度怀疑,以预防 VTE。