Evaluating the Link Between Preoperative Comorbidities and the Risk of Venous Thromboembolism in Patients Undergoing Urological Surgery.

INTRODUCTION

Taking into consideration both the increasing number of elderly patients undergoing surgery and the fragility of this particular category of patients, a decisive step towards more effectively balancing venous thromboembolism (VTE) and bleeding risk is the development of a reliable predicting tool. The aim of this study is to appraise the relationship between comorbidity assessment tools and VTE risk assessment models (RAMs) in patients undergoing urological procedures.

METHODS

Data were prospectively collected during a 20-month period (March 2021-October 2022) including 136 urologic inpatients with a mean age of 66.4 (± 14.4) years. Patients' medical records were reviewed in order to evaluate the comorbidities using the Age-Adjusted Charlson Comorbidity Index (AA-CCI), Cumulative Illness Rating Scale (CIRS), American Society of Anesthesiologists (ASA) score and Index of Co-Existent Diseases (ICED). Venous thromboembolism risk was assessed through the European Association of Urology (EAU) RAM, American Urological Association (AUA) RAM, and Caprini score.

RESULTS

Statistical analysis indicated the presence of a statistically significant relationship between all comorbidity scores and VTE RAMs, with only the CIRS score showing no significant deviations across the EAU RAM risk groups (p=0.111). The positive Kendall's Tau-b coefficient values manifest a positive monotonic relationship between the two variables, meaning that higher comorbidity scores correspond to higher VTE risk categories.

CONCLUSION

Comorbidity scores and VTE RAMs demonstrate a high degree of concordance. This finding suggests that EAU and AUA RAMs, irrespective of their simplicity, can effectively incorporate underlying health conditions and constitute reliable alternatives to the more complex Caprini score.