Novel risk factors for venous thromboembolism following outpatient or inpatient transurethral resection of bladder tumors: Multivariable stepwise and LASSO regression modeling from us insurance claim database
Por:
Laszkiewicz, J, del Giudice, F, Li, S, Krajewski, W, Nowak, L, Szydelko, T, Basran, S, De Berardinis, E, Carino, D, Corvino, R, Santerelli, V, Ferro, M, Rocco, B, Sighinolfi, MC, Crocetto, F, Barone, B, Dinacci, F, Pichler, R, Subiela, JD, Pradere, B, Moschini, M, Mari, A, Gallioli, A, Mori, K, Soria, F, Mertens, L, Abu-Ghanem, Y, Nair, R, Khan, MS, Chung, BI
Publicada:
1 may 2025
Ahead of Print:
1 may 2025
Resumen:
Introduction and Objectives: Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer (BC), which is associated with low risk of venous thromboembolism (VTE). The aim of this study was to find the predictors of postoperative VTE in patients undergoing TURBT for BC.
Materials and Methods: In this retrospective cohort analysis, patients aged >18 years with BC diagnosis undergoing TURBT were identified in the Merative (R) Marketscan (R) Research de-identified databases in 2007-2021. Patients with prior VTE events were excluded. Preoperative diagnostic codes and outpatient prescriptions present in at least 1% of the cohort were recorded (205 variables). Then, logistic regressions were performed including each variable separately, all variables together, as well as variables selected by stepwise and Least Absolute Shrinkage and Selection Operator (LASSO) selection methods. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated.
Results: In total, 132,425 patients were included in this study, with 1,959 (1.5%) individuals diagnosed with postoperative VTE. Various malignant neoplasms diagnosed before BC were significant risk factors of postoperative VTE, with aOR reaching up to 2.26 (95% CI: 1.96-2.61). Another strong predictor of VTE was a diagnosis of nephritis, nephrotic syndrome, and nephrosis (aOR: 1.67; 95% CI: 1.48-1.87 stepwise; aOR: 1.65; 95% CI: 1.46-1.85 LASSO). Also, patients with diseases of the urinary system, non-specific symptoms, diseases of the respiratory system, anemias, and other cardiovascular diseases were associated with increased VTE risk. Regarding drugs, antidiabetic agents and gastrointestinal drugs reduced the probability of VTE.
Conclusions: Numerous preoperative factors have influence on the risk of VTE after TURBT. These findings might facilitate the clinical decision about the implementation of thromboprophylaxis in the appropriate patients. (c) 2025 The Authors. Published by Elsevier Espana, S.L.U. on behalf of AEU. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Filiaciones:
Laszkiewicz, J:
Univ Med Breslavia, Ctr Univ Excelencia Urol, Breslavia, Poland
del Giudice, F:
Univ Stanford, Fac Med, Dept Urol, Stanford, CA 94305 USA
Univ Sapienza Roma, Hosp Policlin Umberto 1, Dept Ciencias Urol & Materno Infantiles, Rome, Italy
Guys & St Thomas Hosp, Guys & St Thomas NHS Fdn Trust, London, England
Li, S:
Univ Med Breslavia, Ctr Univ Excelencia Urol, Breslavia, Poland
Stanford Univ, Dept Dermatol, Sch Med, Stanford, CA USA
Krajewski, W:
Univ Med Breslavia, Ctr Univ Excelenc Urol, Dept Urol Robot & Minimamente Invas, Breslavia, Poland
Nowak, L:
Univ Med Breslavia, Ctr Univ Excelenc Urol, Dept Urol Robot & Minimamente Invas, Breslavia, Poland
Szydelko, T:
Univ Med Breslavia, Ctr Univ Excelencia Urol, Breslavia, Poland
Basran, S:
Univ Stanford, Fac Med, Dept Urol, Stanford, CA 94305 USA
De Berardinis, E:
Univ Sapienza Roma, Hosp Policlin Umberto 1, Dept Ciencias Urol & Materno Infantiles, Rome, Italy
Carino, D:
Univ Sapienza Roma, Hosp Policlin Umberto 1, Dept Ciencias Urol & Materno Infantiles, Rome, Italy
Corvino, R:
Univ Sapienza Roma, Hosp Policlin Umberto 1, Dept Ciencias Urol & Materno Infantiles, Rome, Italy
Santerelli, V:
Univ Sapienza Roma, Hosp Policlin Umberto 1, Dept Ciencias Urol & Materno Infantiles, Rome, Italy
Ferro, M:
Inst Europeo Oncol IEO, Unidad Urol, IRCCS, Mila, Italy
Rocco, B:
Univ Milan, Dept Ciencias Vida, Milan, Italy
ASST Santi Paolo e Carlo, Unidad Urol, Milan, Italy
Sighinolfi, MC:
ASST Santi Paolo e Carlo, Unidad Urol, Milan, Italy
Crocetto, F:
Univ Federico II Napoles, Dept Neurociencias Ciencias Reprod & Odontoestomat, Naples, Italy
Barone, B:
Univ Federico II Napoles, Dept Neurociencias Ciencias Reprod & Odontoestomat, Naples, Italy
Dinacci, F:
Univ Federico II Napoles, Dept Neurociencias Ciencias Reprod & Odontoestomat, Naples, Italy
Pichler, R:
Univ Med Innsbruck, Comprehens Canc Ctr Innsbruck, Serv Urol, Innsbruck, Austria
Subiela, JD:
Univ Alcala, Hosp Univ Ramon y Cajal, Serv Urol, IRYCIS, Madrid, Spain
Pradere, B:
Hosp La Croix Du Sud, Serv Urol, Quint Fonsegrives, France
Moschini, M:
IRCCS Hosp San Raffaele, Serv Urol, Div Oncol Expt, Milan, Italy
Mari, A:
Univ Florencia, Hosp Careggi, Unidad Cirugia Robot Urol & Trasplante Renal, Florencia, Italy
Gallioli, A:
Univ Autonoma Barcelona, Fdn Puigvert, Serv Urol, Barcelona, Spain
Mori, K:
Univ Jikei, Fac Med, Dept Urol, Tokyo, Japan
Univ Med Viena, Serv Urol, Viena, Austria
Soria, F:
Univ Turin, Hosp San Giovanni Battista, Dept Ciencias Quirurg, Div Urol, Turin, Italy
Mertens, L:
Hosp Antoni van Leeuwenhoek, Serv Urol, Inst Oncol Paises Bajos, Amsterdam, Netherlands
Abu-Ghanem, Y:
Guys & St Thomas Hosp, Guys & St Thomas NHS Fdn Trust, London, England
Nair, R:
Guys & St Thomas Hosp, Guys & St Thomas NHS Fdn Trust, London, England
Khan, MS:
Guys & St Thomas Hosp, Guys & St Thomas NHS Fdn Trust, London, England
Chung, BI:
Univ Stanford, Fac Med, Dept Urol, Stanford, CA 94305 USA
Green Submitted, hybrid
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