An International Survey on the Use of Thromboprophylaxis in Urological Surgery

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Violette , P D , Vernooij , R W M , Aoki , Y , Agarwal , A , Cartwright , R , Arai , Y , Tailly , T , Novara , G , Baldeh , T , Craigie , S , Breau , R H , Guyatt , G H & Tikkinen , K 2021 , ' An International Survey on the Use of Thromboprophylaxis in Urological Surgery ' , European Urology Focus , vol. 7 , no. 3 , pp. 653-658 . https://doi.org/10.1016/j.euf.2020.05.015

Title: An International Survey on the Use of Thromboprophylaxis in Urological Surgery
Author: Violette, Philippe D.; Vernooij, Robin W. M.; Aoki, Yoshitaka; Agarwal, Arnav; Cartwright, Rufus; Arai, Yoichi; Tailly, Thomas; Novara, Giacomo; Baldeh, Tejan; Craigie, Samantha; Breau, Rodney H; Guyatt, Gordon H.; Tikkinen, Kari
Contributor organization: Department of Surgery
HUS Abdominal Center
Urologian yksikkö
Department of Public Health
University of Helsinki
Helsinki University Hospital Area
Date: 2021-05
Language: eng
Number of pages: 6
Belongs to series: European Urology Focus
ISSN: 2405-4569
DOI: https://doi.org/10.1016/j.euf.2020.05.015
URI: http://hdl.handle.net/10138/337224
Abstract: Background: The use of perioperative thromboprophylaxis in urological surgery is common but not standardized. Objective: To characterize international practice variation in thromboprophylaxis use in urological surgery. Design, setting, and participants: We conducted a scenario-based survey addressing the use of mechanical and pharmacological thromboprophylaxis in urological cancer procedures (radical cystectomy [RC], radical prostatectomy [RP], and radical nephrectomy [RN]) among practicing urologists in Canada, Finland, and Japan. The survey presented patient profiles reflecting a spectrum of risk for venous thromboembolism; the respondents described their clinical practice. Outcome measurements and statistical analysis: The proportion of respondents who routinely used (1) mechanical, (2) pharmacological, and (3) extended pharmacological prophylaxis was stratified by procedure. A logistic regression identified characteristics associated with thromboprophylaxis use. Results and limitations: Of 1051 urologists contacted, 570 (54%) participated in the survey. Japanese urologists were less likely to prescribe pharmacological prophylaxis than Canadian or Finnish urologists (p < 0.001 for all procedures). Canadian and Finnish urologists exhibited large variation for extended pharmacological prophylaxis for RP and RN. Finnish urologists were most likely to prescribe extended prophylaxis versus Canadian and Japanese urologists (RC 98%, 84%, and 26%; Open RP 25%, 8%, and 3%; robotic RP 11%, 9%, and 0%; and RN 43%, 7%, and 1%, respectively; p < 0.001 for each procedure). Less variation was found regarding the prescription of mechanical prophylaxis, which was most commonly used until ambulation or discharge. The length of hospital stay was longer in Japan and may bias estimates of extended prophylaxis in Japan.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
BLEEDING
Deep vein thrombosis
GUIDELINE
HEMORRHAGE
Practice variation
PREVENTION
Pulmonary embolism
SURGERY
THROMBOPROPHYLAXIS
THROMBOSIS
Urology
VENOUS THROMBOEMBOLISM
Bleeding
Deep vein thrombosis
Guideline
Hemorrhage
Practice variation
Prevention
Pulmonary embolism
Surgery
Thromboprophylaxis
Thrombosis
Urology
Venous thromboembolism
PROCEDURE-SPECIFIC RISKS
VENOUS THROMBOEMBOLISM
CANCER-SURGERY
PROPHYLAXIS
THROMBOSIS
GUIDELINES
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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