Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer (BC), which is associated with low risk of venous thrombo-embolism (VTE). The aim of this study was to find the predictors of postoperative VTE in patients undergoing TURBT for BC.
In this retrospective cohort analysis, patients aged ≥18 years with BC diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases in 2007-2021. Patients with prior VTE events were excluded. Preoperative diagnostic codes and outpatient prescriptions present in at least 1% of the cohort were recorded (205 variables). Then, logistic regressions were performed including each variable separately, all variables together, as well as variables selected by stepwise and Least Absolute Shrinkage and Selection Operator (LASSO) selection methods. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated.
In total, 132,425 patients were included in this study, with 1,959 (1.5%) individuals diagnosed with postoperative VTE. Various malignant neoplasms diagnosed before BC were significant risk factors of postoperative VTE, with aOR reaching up to 2.26 (95% CI: 1.96 - 2.61). Another strong predictor of VTE was a diagnosis of nephritis, nephrotic syndrome, and nephrosis (aOR 1.67, 95% CI: 1.48 - 1.87 stepwise; aOR 1.65, 95% CI: 1.46 - 1.85 LASSO). Also, patients with diseases of the urinary system, non-specific symptoms, diseases of the respiratory system, anemias, and other cardiovascular diseases were associated with increased VTE risk. Regarding drugs, antidiabetic agents and gastrointestinal drugs reduced the probability of VTE.
Numerous preoperative factors have influence on the risk of VTE after TURBT. These findings might facilitate the clinical decision about the implementation of thromboprophylaxis in the appropriate patients.
Actas urologicas espanolas. 2025 Mar 17 [Epub ahead of print]
J Łaszkiewicz, F Del Giudice, S Li, W Krajewski, Ł Nowak, T Szydełko, S Basran, E De Berardinis, D Carino, R Corvino, V Santerelli, M Ferro, B Rocco, M C Sighinolfi, F Crocetto, B Barone, F Dinacci, R Pichler, J D Subiela, B Pradere, M Moschini, A Mari, A Gallioli, K Mori, F Soria, L Mertens, Y Abu-Ghanem, R Nair, M Shamim Khan, B I Chung
Centro Universitario de Excelencia en Urología, Universidad de Medicina de Breslavia, Breslavia, Poland., Departamento de Urología, Facultad de Medicina de la Universidad de Stanford, Stanford, CA, United States; Departamento de Ciencias Urológicas y Materno-Infantiles, Universidad Sapienza de Roma, Hospital Policlínico Umberto I, Roma, Italy; Guy's and St. Thomas' NHS Foundation Trust, Guy's and St Thomas' Hospital, London, United Kingdom. Electronic address: ., Centro Universitario de Excelencia en Urología, Universidad de Medicina de Breslavia, Breslavia, Poland; Departamento de Dermatología, Facultad de Medicina de la Universidad de Stanford, Stanford, CA, United States., Departamento de Urología Robótica y Mínimamente Invasiva, Centro Universitario de Excelencia en Urología, Universidad de Medicina de Breslavia, Breslavia, Poland., Departamento de Urología, Facultad de Medicina de la Universidad de Stanford, Stanford, CA, United States., Departamento de Ciencias Urológicas y Materno-Infantiles, Universidad Sapienza de Roma, Hospital Policlínico Umberto I, Roma, Italy., Unidad de Urología, Instituto Europeo de Oncología (IEO), IRCCS, Milán, Italy., Departamento de Ciencias de la Vida, Universidad de Milán, Milán, Italy; Unidad de Urología, ASST Santi Paolo e Carlo, Milán, Italy., Unidad de Urología, ASST Santi Paolo e Carlo, Milán, Italy., Departamento de Neurociencias, Ciencias de la Reproducción y Odontoestomatología, Universidad Federico II de Nápoles, Nápoles, Italy., Servicio de Urología, Comprehensive Cancer Center Innsbruck, Universidad de Medicina de Innsbruck, Innsbruck, Austria., Servicio de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain., Servicio de Urología, Hospital La Croix Du Sud, Quint Fonsegrives, France., División de Oncología Experimental, Servicio de Urología, IRCCS Hospital San Raffaele, Milán, Italy., Unidad de Cirugía Urológica Robótica y Trasplante Renal, Hospital Careggi, Universidad de Florencia, Florencia, Italy., Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain., Departamento de Urología, Facultad de Medicina de la Universidad Jikei, Tokio, Japan; Departamento de Urología, Universidad de Medicina de Viena, Viena, Austria., División de Urología, Departamento de Ciencias Quirúrgicas, Hospital San Giovanni Battista, Universidad de Turín, Turín, Italy., Servicio de Urología, Instituto Oncológico de los Países Bajos, Hospital Antoni van Leeuwenhoek, Ámsterdam, The Netherlands., Guy's and St. Thomas' NHS Foundation Trust, Guy's and St Thomas' Hospital, London, United Kingdom.