Pharmacological venous thromboembolism prophylaxis in radical prostatectomy
Med Clin (Barc). 2020 Feb 28;154(4):113-118.
doi: 10.1016/j.medcli.2019.04.023.
Epub 2019 Jul 1.
[Article in
English,
Spanish]
Authors
Sebastian Valverde-Martinez
1
, Laura-Andrea Gonzalez-Rayo
2
, Barbara Padilla-Fernandez
3
, Jorge Pereira-Bruno
4
, Hugo Coelho
5
, Manuel Montesino-Semper
6
, Carlos Müller-Arteaga
7
, Jose-Luis Alvarez-Ossorio-Fernandez
8
, Filippo Migliorini
9
, Maria-Begoña Garcia-Cenador
10
, Maria-Fernanda Lorenzo-Gomez
11
Affiliations
- 1 Grupo de Investigación Multidisciplinar Urológico de Renal (GRUMUR), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España; Servicio de Urología, Complejo Asistencial Universitario de Ávila, Ávila, España.
- 2 Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia.
- 3 Servicio de Urología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España.
- 4 Servicio de Urología, Hospital Universitário Pêro da Covilhã, Covilhã, Portugal.
- 5 Servicio de Urología, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
- 6 Servicio de Urología, Hospital Universitario Virgen del Camino, Pamplona, España.
- 7 Servicio de Urología, Complejo Universitario Hospitalario de Ourense, Ourense, España.
- 8 Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
- 9 Servicio de Urología, Hospital Azienda Ospedaliera Universitaria Integrata, Verona, Italia.
- 10 Departamento de Cirugía, Universidad de Salamanca, Salamanca, España.
- 11 Grupo de Investigación Multidisciplinar Urológico de Renal (GRUMUR), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España; Departamento de Cirugía, Universidad de Salamanca, Salamanca, España; Servicio de Urología, Hospital Universitario de Salamanca, Salamanca, España. Electronic address: mflorenzogo@yahoo.es.
Abstract
Background and aim:
Pulmonary thromboembolism is one of the most common causes of non-surgical death in patients following urological abdominopelvic surgery. Since the beginning of prophylaxis for venous thromboembolic disease, episodes of deep vein thrombosis and pulmonary thromboembolism have decreased. Our objective is to analyse the prognosis factors of thromboembolic disease, the clinical variability in the use of pharmacological prophylaxis and the results of its application.
Material and methods:
Retrospective multicentric study of 610 patients undergoing radical prostatectomy between December 2013 and November 2014, in 7general hospitals in Spain, Italy and Portugal. Patients were classified according to their baseline characteristics into thrombotic risk groups and haemorrhagic risk groups. The venous thromboembolic events that occurred in the different groups were analysed.
Results:
The average age was 65.22years (48-78). The average body mass index was 26.7 and the average ASA risk 2.1. In all patients, early mobilization began in the first 24hours. In 4.1% intermittent pneumatic compression was used and 84.6% received pharmacological prophylaxis with low molecular weight heparins. Only 3.4% used the combination of mechanical prophylaxis with pharmacological prophylaxis. We observed a decrease in the incidence of thromboembolic events in the patients who received pharmacological prophylaxis, with an absolute risk reduction of 6.8%. There was no increase in the risk of haemorrhage in the patients who received pharmacological prophylaxis.
Conclusions:
In this study on patients undergoing radical prostatectomy, there was no difference in haemorrhagic complications derived from the use of pharmacological prophylaxis for venous thromboembolic disease. Pharmacological prophylaxis reduces the risk of presenting a thromboembolic event in patients undergoing radical prostatectomy, although this risk is not associated with the approach technique.
Keywords:
Clinical variability; Profilaxis tromboembólica; Prostatectomía radical; Radical prostatectomy; Thromboembolic prophylaxis; Variabilidad clínica.
Copyright © 2019 Elsevier España, S.L.U. All rights reserved.
Publication types
-
Multicenter Study
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Observational Study
MeSH terms
-
Aged
-
Anticoagulants / adverse effects
-
Anticoagulants / therapeutic use
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Heparin, Low-Molecular-Weight / adverse effects
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Heparin, Low-Molecular-Weight / therapeutic use
-
Humans
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Male
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Middle Aged
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Postoperative Complications / prevention & control*
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Postoperative Hemorrhage / chemically induced
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Prostatectomy / adverse effects*
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Retrospective Studies
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Venous Thromboembolism / prevention & control*
Substances
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Anticoagulants
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Heparin, Low-Molecular-Weight