By: Ed Susman

ATLANTA, GA – The incidence of life-threatening pulmonary embolism or deep-vein thrombosis appears to occur most often after cystectomy, compared with other urological surgeries, researchers said at the American Urological Association 2012 Annual Scientific Meeting.

In scrutinising the American College of Surgeons National Surgical Quality Improvement Program Database, researchers observed a 5.25% incidence of pulmonary embolism or deep-vein thrombosis in the 343 patients undergoing cystectomy. That compared with an incidence of 0.73% among the 824 patients undergoing laparoscopic total nephrectomy, which was the lowest rate among the analysed surgeries, said Dae Kim, MD, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

The rates of pulmonary embolism or deep-vein thrombosis were 2.30% in patients undergoing a laparoscopic partial nephrectomy, 1.98% with open partial nephrectomy, 1.96% with open total nephrectomy, 1.69% with open prostatectomy, and 0.95% with laparoscopic prostatectomy. The overall rate of pulmonary embolism/deep-vein thrombosis among the 5,396 patients in the database undergoing any procedure was 1.54%.

“Overall, 83 deep-vein thromboses or pulmonary embolisms were diagnosed in this series,” Dr. Kim said.

Those who were diagnosed with the blood clots were older than the rest of the population undergoing surgery (65 vs 61 years; P =.0003). Dr. Kim said that 87.1% of the patients who developed clots were men, and men made up 58.4% of those who did not experience deep-vein thromboses or pulmonary emboli (P <.001). Body mass index, surgical classification, smoking status, and bleeding disorders did not appear to differ substantially between those who developed the blood clots and those who did not.

Most laboratory values did show statistical differences between the groups, although blood urea nitrogen and haematocrit levels were statistically significantly higher in patients who developed blood clots.

Most of the deep-vein thromboses and pulmonary emboli were detected during the hospital stay, and patients symptomatic for the clots had a substantially longer length of stay (3.8 vs 11.9 days; P <.0001).

- MFP Wire Services
- 06-05-2012