Abstract：
OBJECTIVE:To examine the use of in-hospital pharmacologic thromboprophylaxis (PTP) in patients undergoing radical cystectomy between 2004 and 2014 and to assess the risk of venous thromboembolism (VTE) across the study period. MATERIAL AND METHODS:We identified 8322 patients without contraindications to PTP undergoing radical cystectomy in the US using the Premier Healthcare Database. Nonparametric Wilcoxon type test for trend was employed to examine the trend of PTP utilization across the study period. Ensuing, we employed multivariable logistic regression and generalized linear regression models to examine the odds of receiving PTP and the risk of being diagnosed with VTE, respectively. RESULTS:Based on VTE risk-stratification, the majority of patients (87.8%) qualified as "high-risk." Across the study period the use of PTP increased (Odds ratio 1.02, 95% confidence interval (CI) 1.00-1.03, P = .044), but remained underutilized as the maximum percentage of patients receiving in-hospital PTP did not exceed 58.6%. The risk of VTE did not vary across the study period (risk ratio 0.97, 95%CI 0.92-1.02, P = .178). CONCLUSION:Utilization of PTP increased throughout the study period, while the risk of VTE did not change. Future studies are necessary to improve implementation of guideline-driven care, as PTP remained underutilized throughout the study period.
journal_name
Urologyjournal_title
Urologyauthors
Tully KH,Krimphove MJ,Reese SW,Kibel AS,Noldus J,Krasnow RE,Trinh QD,Sonpavde GP,Chang SL,Mossanen Mdoi
10.1016/j.urology.2019.09.029subject
Has Abstractpub_date
2020-01-01 00:00:00pages
44-49eissn
0090-4295issn
1527-9995pii
S0090-4295(19)30864-7journal_volume
135pub_type
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