EAU 2011 - Open radical prostatectomy (ORP) performed by low volume surgeons predisposes to higher rates of venous thrombosis (VT) and pulmonary embolism (PE) - Session Highlights

VIENNA, AUSTRIA (UroToday.com) - In this presentation, Dr. Jan Schmitges and a group of international collaborators examined the most contemporary VT and PE rates and temporal trends in a large population-based cohort.

Between 1999 and 2008, 34,653 ORPs were performed in the state of Florida. Rates and trends of VT and PE were assessed. Univariate and multivariable logistic regression analyses focused on prediction of VT and PE. Predictors included age, race, surgical volume tertiles (SV), and baseline Charlson Comorbidity Index (CCI).

The rate of VT (0.3-0.2%, P=0.3) and PE (0.1-0.1%, P=0.5) remained stable over the study period. VT was indirectly related to SV: VT rate was 0.3% at ORP performed within the low SV tertile vs. 0.1% in the intermediate and high SV tertile (P<0.001). In 21.3% of patients suffering from VT, a PE also occurred (P<0.001). PE was significantly higher in patients operated within the low and intermediate SV tertile vs. those operated in the high SV tertile (0.2 vs. 0.2 vs. 0.1%, P=0.02). In-hospital mortality rate was 0.07% in patients not suffering from PE and 11.3% in patients with PE (P<0.001). After adjusting for all covariates, patients operated by low SV surgeons were 3.7 times more likely to have VT than patients operated by high SV surgeons (P=0.001). In multivariable analysis for prediction of PE, patients operated within the low SV tertile were 2.6-fold more likely to suffer from PE vs. those operated in the intermediate and high SV tertile (P=0.02). Age and CCI failed to reach statistical significance in univariate and multivariable analyses for both end points.


Presented by Jan Schmitges, MD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria


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