Patients and Methods
Patients
Characteristic | With VTE | Without VTE | p Valueb |
---|---|---|---|
(n = 1,180, 1%)a | (n = 195,735, 99%)a | ||
n (%) | n (%) | ||
Median age: years (IQR) | 67 (60–74) | 63 (57–69) | < 0.001 |
Female sex | 271 (23) | 27,543 (14) | < 0.001 |
Median hospital stay: days (IQR) | 10 (6–17) | 2 (1–4) | < 0.001 |
Charlson Comorbidity Index | < 0.001 | ||
0 | 584 (49) | 149,923 (70) | |
1 | 274 (22) | 29,891 (15) | |
2 | 88 (8) | 5,489 (3) | |
≥3 | 234 (20) | 10,432 (5) | |
Neoadjuvant chemotherapy | 49 (4.2) | 2,284 (1,2) | < 0.001 |
Smoking habit | 299 (25) | 38,817 (20) | < 0.001 |
Obesity | 215 (18) | 24,286 (12) | < 0.001 |
Race/ethnicity | 0.09 | ||
Caucasian | 846 (72) | 136,407 (70) | |
African–American | 144 (12) | 22,204 (11) | |
Hispanic | 72 (6) | 13,924 (7) | |
Others | 118 (10) | 23,200 (12) | |
Insurance status | <0.001 | ||
Private | 389 (33) | 95,526 (50) | |
Medicaid | 74 (6) | 9,229 (5) | |
Medicare | 665 (56) | 78,451 (40) | |
Others | 52 (4) | 9,529 (5) | |
Income | 0.05 | ||
First quartile | 315 (27) | 46,698 (24) | |
Second quartile | 293 (25) | 46,693 (24) | |
Third quartile | 284 (24) | 50,359 (26) | |
Fourth quartile | 288 (24) | 51,985 (27) | |
High annual hospital volume | 227 (19) | 39,310 (20) | 0.5 |
Region | 0.03 | ||
Northeast | 258 (22) | 38,070 (19) | |
Midwest | 302 (26) | 46,558 (24) | |
South | 406 (34) | 73,005 (37) | |
West | 214 (18) | 38,102 (19) | |
Teaching hospital | 936 (79) | 146,773 (75) | < 0.001 |
Statistical Analysis
Results
Descriptive Characteristics
Characteristic | With PE | Without PE | p Valueb |
---|---|---|---|
(n = 583, 0.3%)a | (n = 196,332, 99.7%)a | ||
n (%) | n (%) | ||
Median age: years (IQR) | 66 (58–73) | 63 (57, 69) | < 0.001 |
Female sex | 120 (21) | 27,694 (14) | < 0.001 |
Median hospital stay: days (IQR) | 10 (7–16) | 2 (1–4) | < 0.001 |
Charlson Comorbidity Index | < 0.001 | ||
0 | 299 (51) | 150,208 (77) | |
1 | 131 (22) | 30,034 (15) | |
2 | 44 (8) | 5,533 (3) | |
≥3 | 109 (19) | 10,557 (6) | |
Neoaduvant chemotherapy | 23 (4) | 2,310 (1.2) | < 0.001 |
Smoking habit | 140 (24) | 38,976 (20) | 0.012 |
Obesity | 106 (18) | 24,395 (12) | < 0.001 |
Race/ethnicity | 0.003 | ||
Caucasian | 417 (72) | 136,836 (70) | |
African–American | 80 (14) | 22,268 (11) | |
Hispanic | 29 (5) | 13,967 (7) | |
Others | 57 (10) | 23,261 (12) | |
Insurance status | < 0.001 | ||
Private | 192 (33) | 98,723 (50) | |
Medicaid | 38 (7) | 9,265 (5) | |
Medicare | 327 (56) | 78,789 (40) | |
Others | 26 (4) | 9,555 (5) | |
Income | 0.1 | ||
First quartile | 159 (27) | 46,854 (24) | |
Second quartile | 143 (25) | 46,843 (24) | |
Third quartile | 138 (24) | 50,505 (26) | |
Fourth quartile | 143 (25) | 52,130 (27) | |
High annual hospital volume | 100 (17) | 39,437 (20) | 0.3 |
Region | 0.2 | ||
Northeast | 133 (23) | 38,195 (19) | |
Midwest | 133 (23) | 46,727 (24) | |
South | 199 (34) | 73,212 (37) | |
West | 118 (20) | 38,198 (19) | |
Teaching hospital | 447 (77) | 147,262 (75) | 0.4 |
Annual Trends in Venous Thromboembolism and Mortality with Venous Thromboembolism Among Patients Undergoing Major Urologic Cancer Surgery
Annual Trends in Pulmonary Embolism and Mortality with Pulmonary Embolism Among Patients Undergoing Major Urologic Cancer Surgery
Annual Trends in the Charlson Comorbidity Index, Obesity, and Age 69 Years or Older Among Patients Undergoing Major Urologic Cancer Surgery
Distribution of Venous Thromboembolism and Pulmonary Embolism Rates After Major Urologic Cancer Surgery
Surgery | Overall (n = 196,915, 100%) | With VTE | With PE |
---|---|---|---|
n (%) | n (%) | n (%) | |
Radical cystectomy (RC)a | 14,362 (7.3) | 377/14,362 (2.6) | 170/14,362 (1.2) |
Open RC | 10,319 (71.8) | 283/10,319 (2.7) | 124/10,319 (1.2) |
Minimally invasive RC | 4,043 (28.2) | 94/4,043 (2.3) | 46/4,043 (1.1) |
Radical nephrectomy (RN)b | 885 (22.2) | 472/43,885 (1.1) | 203/43,885 (0.5) |
Open RN | 34,877 (79.5) | 393/34,877 (1.1) | 169/34,877 (0.5) |
Minimally invasive RN | 9,008 (20.5) | 79/9,008 (0.9) | 34/9,008 (0.4) |
Partial nephrectomy (PN)c | 25,211 (12.8) | 160/25,211 (0.6) | 107/25,211 (0.4) |
Open PN | 11,425 (45.3) | 92/11,425 (0.8) | 61/11,425 (0.5) |
Minimally invasive PN | 13,786 (54.6) | 68/13,786 (0.5) | 46/13,786 (0.3) |
Radical prostatectomy (RP)d | 113,457 (57.6) | 171/113,457 (0.2) | 103/113,457 (0.09) |
Open RP | 24,938 (22.0) | 60/24,938 (0.2) | 43/24,938 (0.2) |
Minimally invasive RP | 88,519 (78.0) | 111/88,519 (0.1) | 60/88,519 (0.07) |
Multivariable Logistic Regression Models Predicting Venous Thromboembolism After Major Urologic Cancer Surgery Relative to Radical Prostatectomy
Characteristic | OR | 95% CI | p Value |
---|---|---|---|
(a) | |||
Major urologic cancer surgery | |||
Radical prostatectomy | Reference | – | – |
Radical cystectomy | 4.9 | 3.8–6.4 | < 0.001 |
Radical nephrectomy | 4.5 | 3.5–5.7 | < 0.001 |
Partial nephrectomy | 3.6 | 2.7–4.7 | < 0.001 |
(b) | |||
Major urologic cancer surgery | |||
Radical prostatectomy | Reference | – | – |
Radical cystectomy | 4.4 | 3.1–6.2 | < 0.001 |
Radical nephrectomy | 3.2 | 2.3–4.5 | < 0.001 |
Partial nephrectomy | 3.9 | 2.8–5.4 | < 0.001 |
Multivariable Logistic Regression Models Predicting Pulmonary Embolism After Major Urologic Cancer Surgery Relative to Radical Prostatectomy
Multivariable Logistic Regression Models Predicting Mortality with Venous Thromboembolism After Major Urologic Cancer Surgery
(a) Venous thromboembolism (VTE) | (b) Pulmonary embolism (PE) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Mortality with VTE (%) | Univariable | Multivariablea | Mortality with PE (%) | Univariable | Multivariablea | |||||
OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | OR (95% CI) | p Value | |||
Radical cystectomy | 13.1 | 6.0 (4.0–8.9) | < 0.001 | 3.7 (2.3–5.8) | < 0.001 | 8.0 | 7.9 (4.8–13.0) | < 0.001 | 4.9 (2.7–8.6) | < 0.001 |
Radical nephrectomy | 11.2 | 12.4 (8.4–18.2) | < 0.001 | 5.2 (3.1–8.8) | < 0.001 | 7.1 | 18.1 (11.1–29.4) | < 0.001 | 8.3 (4.2–16.5) | < 0.001 |
Partial nephrectomy | 13.4 | 24.5 (10.9–54.5) | < 0.001 | – | 11.5 | 32.1 (13.7–76.5) | – | |||
Radical prostatectomy | 9.6 | 72.6 (28.7–183.0) | < 0.001 | – | 7.7 | 95.4 (33.7–269.9) | – |