Mp67-13 Balancing Vte Prevention and Bleeding Risk in Partial Nephrectomy Utilizing the Caprini Score

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-13 BALANCING VTE PREVENTION AND BLEEDING RISK IN PARTIAL NEPHRECTOMY UTILIZING THE CAPRINI SCORE Sarah Hampton, Mark Falstin, David Thiel, Emily Brennan, Aaron Spaulding, and Michael Edwards Sarah HamptonSarah Hampton , Mark FalstinMark Falstin , David ThielDavid Thiel , Emily BrennanEmily Brennan , Aaron SpauldingAaron Spaulding , and Michael EdwardsMichael Edwards View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Venous thromboembolism (VTE) following partial nephrectomy occurs in approximately 2% of patients. There are currently no guidelines for VTE prophylaxis in partial nephrectomy cases, and chemoprophylaxis must be balanced with bleeding risk considerations. While validated VTE risk assessment measures (RAMs) are available, there use to guide risk assessment and prevention measures in partial nephrectomy is also uncertain. Our study aim was to determine the use and impact of Caprini-directed venous thromboembolism prophylaxis in patients undergoing partial nephrectomy. METHODS: All elective partial nephrectomies performed at our center between 2016 and 2021 were retrospectively reviewed. Caprini score and VTE prophylaxis regimen were retrospectively determined. The primary outcome was receipt of Caprini guideline indicated VTE prophylaxis. Secondary outcomes included postoperative VTE and bleeding. Bivariate analysis compared outcomes between prophylaxis cohorts. Multivariate regression models determined independent predictors of receiving risk guided prophylaxis or experiencing VTE or bleeding. RESULTS: Of 1,109 partial nephrectomy cases, 89% were high VTE risk patients, and overall inpatient, 30- and 90-day VTE rates were 0.63%, 0.21% and 0.31%, respectively. Twenty-eight percent received appropriate inpatient prophylaxis, with similar inpatient VTE (0.73% vs. 0.33%, p 0.427) and bleeding (3.1% vs. 1.6%, p 0.172) rates between those receiving and not receiving appropriate risk-based prophylaxis. Compared to hospital site one, patient having procedures performed at hospital site two (OR 0.10, CI: 0.06, 0.14) and site three (OR 0.02, CI: 0.01, 0.05) were less likely to receive appropriate Caprini guided VTE prophylaxis. Appropriate prophylaxis did not independently reduce VTE risk (OR 0.46, CI: 0.02, 2.78) nor increase bleeding risk (OR 0.43, CI: 0.13-1.2). Bleeding was independently associated with non-Hispanic Other race (OR 5.73, CI: 1.26-19.13) and Charlson score (OR 1.49, CI: 1.13-1.96). CONCLUSIONS: In this partial nephrectomy cohort, receipt of Caprini guideline indicated thromboprophylaxis was not associated with a significant reduction in VTE rate nor an increase in bleeding rate. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1102 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sarah Hampton More articles by this author Mark Falstin More articles by this author David Thiel More articles by this author Emily Brennan More articles by this author Aaron Spaulding More articles by this author Michael Edwards More articles by this author Expand All Advertisement PDF downloadLoading ...