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Patients who undergo surgery for bladder cancer may require long-term prophylaxis for venous thromboembolism (VTE), according to research published in BJU International.
The study showed an increase in VTE incidence over time, with more than half of VTEs occurring after patients were discharged from the hospital.
In addition, VTE was associated with an increased risk of death—from the cancer or any cause.
The study included 3879 patients from the Ontario Cancer Registry who had radical cystectomy to treat bladder cancer between 1994 and 2008.
Within 1 month of their surgical admission date, 3.6% of patients had been diagnosed with VTE. The VTE incidence increased to 4.7% by 2 months and 5.4% by 3 months.
In all, 55% of VTE events occurred after hospital discharge, which is generally when patients are not receiving VTE prophylaxis.
“Although the findings in this population-based study confirmed some previous understanding of the frequency of VTE for this complex surgery, we were surprised at the number that were diagnosed after hospital discharge,” said study author D. Robert Siemens, MD, of Queen’s University in Kingston, Ontario, Canada.
“Furthermore, we were unable to identify strong predictive factors associated with VTE, suggesting to us that most all patients should receive prolonged VTE prophylaxis well beyond their hospital discharge.”
More specifically, the researchers conducted a multivariate analysis and found that higher surgeon volume and increased length of hospital stay were the only factors significantly associated with VTE (P=0.004 and P<0.001, respectively).
The team also discovered that patients with VTE tended to die earlier. VTE was associated with inferior cancer-specific survival and overall survival. The hazard ratios were 1.35 and 1.27, respectively.
Dr Siemens said these results suggest VTE could represent a marker of more aggressive disease. 
Image by Andre E.X. Brown
Patients who undergo surgery for bladder cancer may require long-term prophylaxis for venous thromboembolism (VTE), according to research published in BJU International.
The study showed an increase in VTE incidence over time, with more than half of VTEs occurring after patients were discharged from the hospital.
In addition, VTE was associated with an increased risk of death—from the cancer or any cause.
The study included 3879 patients from the Ontario Cancer Registry who had radical cystectomy to treat bladder cancer between 1994 and 2008.
Within 1 month of their surgical admission date, 3.6% of patients had been diagnosed with VTE. The VTE incidence increased to 4.7% by 2 months and 5.4% by 3 months.
In all, 55% of VTE events occurred after hospital discharge, which is generally when patients are not receiving VTE prophylaxis.
“Although the findings in this population-based study confirmed some previous understanding of the frequency of VTE for this complex surgery, we were surprised at the number that were diagnosed after hospital discharge,” said study author D. Robert Siemens, MD, of Queen’s University in Kingston, Ontario, Canada.
“Furthermore, we were unable to identify strong predictive factors associated with VTE, suggesting to us that most all patients should receive prolonged VTE prophylaxis well beyond their hospital discharge.”
More specifically, the researchers conducted a multivariate analysis and found that higher surgeon volume and increased length of hospital stay were the only factors significantly associated with VTE (P=0.004 and P<0.001, respectively).
The team also discovered that patients with VTE tended to die earlier. VTE was associated with inferior cancer-specific survival and overall survival. The hazard ratios were 1.35 and 1.27, respectively.
Dr Siemens said these results suggest VTE could represent a marker of more aggressive disease.
Image by Andre E.X. Brown
Patients who undergo surgery for bladder cancer may require long-term prophylaxis for venous thromboembolism (VTE), according to research published in BJU International.
The study showed an increase in VTE incidence over time, with more than half of VTEs occurring after patients were discharged from the hospital.
In addition, VTE was associated with an increased risk of death—from the cancer or any cause.
The study included 3879 patients from the Ontario Cancer Registry who had radical cystectomy to treat bladder cancer between 1994 and 2008.
Within 1 month of their surgical admission date, 3.6% of patients had been diagnosed with VTE. The VTE incidence increased to 4.7% by 2 months and 5.4% by 3 months.
In all, 55% of VTE events occurred after hospital discharge, which is generally when patients are not receiving VTE prophylaxis.
“Although the findings in this population-based study confirmed some previous understanding of the frequency of VTE for this complex surgery, we were surprised at the number that were diagnosed after hospital discharge,” said study author D. Robert Siemens, MD, of Queen’s University in Kingston, Ontario, Canada.
“Furthermore, we were unable to identify strong predictive factors associated with VTE, suggesting to us that most all patients should receive prolonged VTE prophylaxis well beyond their hospital discharge.”
More specifically, the researchers conducted a multivariate analysis and found that higher surgeon volume and increased length of hospital stay were the only factors significantly associated with VTE (P=0.004 and P<0.001, respectively).
The team also discovered that patients with VTE tended to die earlier. VTE was associated with inferior cancer-specific survival and overall survival. The hazard ratios were 1.35 and 1.27, respectively.
Dr Siemens said these results suggest VTE could represent a marker of more aggressive disease.