371 Anticoagulation Management in Urological Surgical Patients

Aim Anticoagulation management in urology surgery involves a trade-off between decreased risk of venous thromboembolism and increase of risk of bleeding which ultimately affects patient’s quality of care and complication rate. This audit is intended to review the current anticoagulation management of the uro-surgical patients, audited against local policies at Kingston Hospital NHS Foundation trust:” VTE assessment in adults “and “guideline for the interruption of anticoagulant and antiplatelet drugs before surgery and invasive procedures”. Method Data have been collected retrospectively via computer archives. The sample encompasses elective adults patients undergoing urological surgical procedures. The sample consisted in 167 adult patients, operated between January 2022 and July 2023. Results 97% (162/167) were appropriately assessed for the risk of VTE.2.9% (5/167) were not assessed. 0% (0/40) uro-surgical patients on chronic anticoagulation were stratified for the risk of bleeding and thrombosis before the surgery. 127/167 analysed patients were not included as were not on anticoagulation medication at the time of surgery.62.5% (25/40) received a proper anticoagulation bridging plan. 37.5% (15/40) patients were discharged without bridging plan. 5% (2/40) patients were check-listed for Anticoagulation bridging. 0% (0/167) were assessed for the VTE risk at 24h as per protocol. Conclusions Overall, the audit showed substandard management of anticoagulation bridging in uro-surgical patients. Patients were not appropriately stratified for their individual and procedure-based bleeding risks. The anticoagulation bridging was not appropriately completed for all the patients. The post operative management including the checklist at 24 hours VTE re-assessment was not done for any of the admitted patients. Improvements are urgently needed.