Radical Cystectomy Patients May Need Longer VTE Prophylaxis

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Patients undergoing radical cystectomy for bladder cancer may require prolonged pharmacologic prophylaxis against venous thromboembolism (VTE), new data suggest.

Amanda A. VanDlac, MD, of Oregon Health and Science University in Portland, and colleagues analyzed data from 1,307 radical cystectomy patients. Of these, VTE was diagnosed in 78 (6%), the researchers reported online ahead of print in The Journal of Urology. The mean time to diagnosis was 15.2 days after surgery; 55% of all VTE events were diagnosed after patient discharge. The 30-day mortality rate from VTE was 6.4%.

In multivariate analysis, risk factors for VTE were increasing age, longer operative time, and sepsis or septic shock, according to the investigators.

The authors concluded that it is reasonable to consider extended pharmacologic prophylaxis (four weeks) in this high-risk surgical population.

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