Washington, DC USA (UroToday.com) In today’s SUO meeting poster session Matulewicz Richard and colleagues from Northeastern University presented their data on venous thromboembolism (VTE) after nephrectomies. It is known that VTE has significant consequences on surgical patients’ morbidity and mortality. The authors hypothesized that there are potentially modifiable risk factors that differentially influence the rate of VTE after open and minimally invasive (MIS) nephrectomy.
In this study, the authors determined the potential modifiable risk factors associated with VTE in patients undergoing nephrectomy. They used the ACS-NSQIP database between the years 2006-2012 and extracted all the patients undergoing nephrectomy with either an\ open or MIS approach. Descriptive statistics were performed and a binomial logistic regression model was constructed. The authors found a rate of 0.8% for DVT and 0.5% for PE. Then the authors compared different factors between the DVT and PE groups compared with no DVT and no PE groups respectively. Higher rates of dyspnea, diabetes, CVA, high ASA score, operative time, rates of readmissions and death were found in the DVT group compared with no DVT group. Similarly, higher rates of dyspnea, readmissions and death were found in the PE group compared with no PE group. Furthermore, higher rates of both PE and DVT were found in patient undergoing open versus MIS nephrectomy. Finally, on multivariate analysis, only dyspnea predicted VTE event after nephrectomy.
The authors conclude that VTE is more common with the open approach and that dyspnea, possibly related to poor mobility or cardiopulmonary disease, contributes the greatest to risk of VTE after nephrectomy.
Richard S. Matulewicz
Northwestern University, Feinberg School of Medicine, Department of Urology
Dr. Miki Haifler, MD from the 2015 Winter Meeting of the Society of Urologic Oncology (SUO) "Defining Excellence in Urologic Oncology" - December 2 - 4 Washington, DC USA
Fox Chase Cancer Center, Philadelphia, PA USA