The incidence of venous thromboembolism and pharmacologic thromboprophylaxis following major urologic surgery: a population-based analysis

Abstract

INTRODUCTION: The incidence of symptomatic venous thromboembolism (VTE), which comprises deep venous thrombosis (DVT) and pulmonary embolism (PE) at a population-based level remains unknown in patients undergoing major urologic surgery. Our aim was to determine the incidence of VTE in major urologic surgery, identify patients who are at high risk for developing these events, and to examine whether the use of pharmacologic thromboprophylaxis is associated with a reduction in the incidence of VTE in major urologic surgery. METHODS: We captured all adult patients who underwent major urologic surgery between January 2005 and December 2010 based on 1CD-9-CM codes from the Perspective Database (Premier, Inc, Charlotte, NC), a nationally representative dataset capturing 25% of US hospital discharges. Major urologic surgery was defined as a radical prostatectomy, radical cystectomy, radical nephrectomy or partial nephrectomy. We used ICD-9-CM codes to identify VTE and major bleeding after major urologic surgery within 90 days after the procedure and hospital billing descriptions to identify if patients had received pharmacologic thromboprophylaxis beginning the day of surgery. Univariate and multivariate analyses were performed using STATA 12 (StataCorp LP, CollegeStation, Texas) after adjusting for sample weights. [TRUNCATED]