[Rate of thrombosis and bleeding after urological surgery under standardized anticoagulation].
Thromboserate und Blutungen in der universitären operativen Urologie unter standardisierter Antikoagulation.
Anticoagulation
Hemorrhage
Risk factors
Thrombosis
Urological surgery
Journal
Der Urologe. Ausg. A
ISSN: 1433-0563
Titre abrégé: Urologe A
Pays: Germany
ID NLM: 1304110
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
pubmed:
22
9
2019
medline:
22
1
2020
entrez:
22
9
2019
Statut:
ppublish
Résumé
According to the current definition of the German guideline for prevention of venous thromboembolism, urological surgery includes a high number of high-risk patients. All patients undergoing urological surgery between 2012 and 2016 were analyzed with regard to complications (bleeding or thrombosis). This study is a retrospective and monocentric cohort study. Included were all patients who underwent surgery between 2012 and 2016 at the Urological Department at the University Hospital of Luebeck. Information was collected relating to anticoagulation, patient-specific and surgery-specific risk factors, and complications. In all, 3609 surgeries were analyzed: 77.8% of patients received no medical prophylaxis, 10.2% received an aggregation inhibitor, and 8.5% synthetic, unfractionated or low molecular weight heparin. Heparin was administered to 80.4% of patients after surgery. During an average hospital stay of 4.5 days, 93.3% of the patients received no change in anticoagulation. Merely 0.8% of all patients suffered from clinical thomboembolic events within 28 days. In contrast the number of bleedings was higher with 20.3% (minor: 4.8%, major: 15.5%). We found a slight risk for postoperative thromboembolism (0.8%). The risk for postoperative bleeding in contrast was 20.3%, including 15.5% major bleedings. The results are discussed in relation to the current guidelines.
Sections du résumé
BACKGROUND
BACKGROUND
According to the current definition of the German guideline for prevention of venous thromboembolism, urological surgery includes a high number of high-risk patients. All patients undergoing urological surgery between 2012 and 2016 were analyzed with regard to complications (bleeding or thrombosis).
MATERIALS AND METHODS
METHODS
This study is a retrospective and monocentric cohort study. Included were all patients who underwent surgery between 2012 and 2016 at the Urological Department at the University Hospital of Luebeck. Information was collected relating to anticoagulation, patient-specific and surgery-specific risk factors, and complications.
RESULTS
RESULTS
In all, 3609 surgeries were analyzed: 77.8% of patients received no medical prophylaxis, 10.2% received an aggregation inhibitor, and 8.5% synthetic, unfractionated or low molecular weight heparin. Heparin was administered to 80.4% of patients after surgery. During an average hospital stay of 4.5 days, 93.3% of the patients received no change in anticoagulation. Merely 0.8% of all patients suffered from clinical thomboembolic events within 28 days. In contrast the number of bleedings was higher with 20.3% (minor: 4.8%, major: 15.5%).
CONCLUSION
CONCLUSIONS
We found a slight risk for postoperative thromboembolism (0.8%). The risk for postoperative bleeding in contrast was 20.3%, including 15.5% major bleedings. The results are discussed in relation to the current guidelines.
Identifiants
pubmed: 31541268
doi: 10.1007/s00120-019-01045-3
pii: 10.1007/s00120-019-01045-3
doi:
Substances chimiques
Anticoagulants
0
Heparin, Low-Molecular-Weight
0
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
40-51Commentaires et corrections
Type : ErratumIn
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