Douroumis Konstantinos, Fragkiadis Evangelos, Moulavasilis Napoleon, Stratigopoulou Panagiota, Adamakis Ioannis, Anastasiou Ioannis, Mitropoulos Dionysios
First Department of Urology, National and Kapodistrian University of Athens, Athens, Greece.
Anesthesiology Department, Laikon General Hospital of Athens, Athens, Greece.
Can Urol Assoc J. 2025 May;19(5):E179-E182. doi: 10.5489/cuaj.8907.
The process for determining thromboprophylaxis decisions in urologic surgery entails assessing the risk of venous thromboembolism (VTE) in comparison to the risk of bleeding. Risk assessment models (RAMs) have been created to systematically calculate an individual's risk of VTE. In our study, we evaluated the risk of VTE in urologic inpatients using two RAMs specifically designed for urology by the European Association of Urology (EAU) and the American Urological Association (AUA), the Caprini score, and the CHA2DS2-VASc score.
The study group consisted of 136 inpatients within the urology department. Data from medical records included information on various factors, such as age, gender, and body mass index, as well as personal and family history of the patients. The risk of VTE was determined using the RAMs provided by EAU and AUA, the Caprini score, and the CHA2DS2-VASc score.
Chemical prophylaxis was advised for 48 (35.3%) patients according to the EAU model, 47 patients (34.6%) according to the AUA model, 128 (94.1%) patients based on the Caprini score, and 80 (58.8%) patients according to the CHA2DS2-VASc score. Limitations of the study include a small sample size and lack of post-surgery venous thromboembolic events recording.
The VTE RAMs developed by the EAU and AUA provide consistent recommendations for thromboembolism prophylaxis in urologic patients, while the Caprini model's strict adherence may lead to excessive prophylaxis recommendations. The EAU approach is user-friendly but urologists must judiciously weigh bleeding and VTE risks on an individual basis, ensuring optimal prophylaxis use.
在泌尿外科手术中确定血栓预防决策的过程需要评估静脉血栓栓塞（VTE）的风险与出血风险。已经创建了风险评估模型（RAMs）来系统地计算个体的VTE风险。在我们的研究中，我们使用欧洲泌尿外科学会（EAU）和美国泌尿外科学会（AUA）专门为泌尿外科设计的两个RAMs、Caprini评分和CHA2DS2-VASc评分来评估泌尿外科住院患者的VTE风险。
研究组由泌尿外科的136名住院患者组成。病历数据包括各种因素的信息，如年龄、性别和体重指数，以及患者的个人和家族病史。使用EAU和AUA提供的RAMs、Caprini评分和CHA2DS2-VASc评分来确定VTE风险。
根据EAU模型，建议对48名（35.3%）患者进行化学预防；根据AUA模型，建议对47名（34.6%）患者进行化学预防；根据Caprini评分，建议对128名（94.1%）患者进行化学预防；根据CHA2DS2-VASc评分，建议对80名（58.8%）患者进行化学预防。该研究的局限性包括样本量小以及缺乏术后静脉血栓栓塞事件记录。
EAU和AUA开发的VTE RAMs为泌尿外科患者的血栓栓塞预防提供了一致的建议，而Caprini模型的严格遵循可能导致过度的预防建议。EAU方法使用方便，但泌尿外科医生必须根据个体情况明智地权衡出血和VTE风险，确保最佳预防措施的使用。
