Risk of Post-operative Thromboembolism in Men Undergoing Urologic Prosthetic Surgery: An Assessment of 21,413 Men

To assess venous thromboembolism (VTE) and associated risk factors following artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) surgery. Using IBM MarketScan, a commercial claims database, patients undergoing AUS and IPP surgery were identified using Current Procedural Termino...

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Bibliographic Details
Published inThe Journal of urology p. 101097JU0000000000002801
Main Authors Hebert, Kevin J, Matta, Rano, Horns, Joshua J, Paudel, Niraj, Das, Rupam, Kohler, Tobias S, Pastuszak, Alexander W, McCormick, Benjamin J, Hotaling, James M, Myers, Jeremy B
Format Journal Article
LanguageEnglish
Published United States 10.06.2022
Subjects
MarketScan
artificial urinary sphincter
deep vein thrombosis
subcutaneous heparin
venous thromboembolism
inflatable penile prosthesis surgery
pulmonary embolism
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Summary:To assess venous thromboembolism (VTE) and associated risk factors following artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) surgery. Using IBM MarketScan, a commercial claims database, patients undergoing AUS and IPP surgery were identified using Current Procedural Terminology (CPT) and ICD-10 procedure codes between 2008 and 2017. ICD-9 and 10 codes were used to identify healthcare visits associated with lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days of surgery. Covariates were assessed using a multivariable model to determine association with outcome of DVT and/or PE. 21,413 men underwent AUS (4870) or IPP (16543) surgery between 2008 and 2017 with a median age of 62 years and 68 years, respectively. DVT or PE events following AUS and IPP surgery occurred in 1.54% and 1.04%, respectively. A history of varicose veins (Hazard Ratio 2.76; 95% CI [1.11-6.79]), prior history of DVT (HR 13.65; 95% CI [7.4-25.19]), or PE (HR 7.65; 95% CI [4.01-14.6]) were highly associated with development of postoperative VTE. Likewise, prior history of DVT (HR 12.6; 95% CI [7.99-19.93]) and PE (HR 8.9; 95% CI [5.6-14.13]) were strongly associated with a VTE event following IPP surgery. In a large cohort of men undergoing AUS and IPP surgery, 1.54% and 1.04% of men experienced a VTE event within 90 days of surgery, respectively. Prior history of varicose veins, DVT, and PE were associated with an increased likelihood of developing a postoperative DVT or PE.
ISSN:1527-3792