AUA 2019: Trends in Extended-Duration Postoperative Venous Thromboembolism Prophylaxis following Radical Cystectomy

Chicago, IL (UroToday.com) Multiple prior studies have demonstrated increased risk of venous thromboembolism (VTE) in pelvic surgeries with an increased risk in patients with malignancy. Growing evidence suggests that risk of VTE after radical cystectomy (RC) may be reduced by discharging patients on extended-duration pharmacologic prophylaxis (EDPP). While this has become common practice in many centers, to what extent this is occurring nationally has not been reported. The aim of this study was to evaluate temporal trends in outpatient EDPP prescribing following RC in the United States (US).

The authors queried the OptumLabs Data warehouse capturing patients with commercial and Medicare Advantage insurance coverage in the US between 2012-2017. Inpatient, outpatient and pharmacy claims were available on 120 million patients, representing 19% of all commercially insured patients. EDPP was defined as a 30-day outpatient prescription for prophylactic dose Enoxaparin, Dalteparin, Fondaparinux, or Heparin.

Of 2054 studied patients, 385 (19%) received EDPP. There was an increasing trend per year from 2012 (9% of cases) to 2017 (26%).

In conclusion, there was a significant increase in the use of EDPP after RC in the US over time between 2012-2017. In 2017, 26% of patients were discharged with EDPP after RC in this insured patient cohort which represents 19% of all commercially ensured patients.

Presented by: Timothy Lyon, MD, Mayo Clinic

Written By: Selma Masic, MD, Urologic Oncology Fellow (SUO), Fox Chase Cancer Center, @selmasic at American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois

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