The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data
Abstract Objectives To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in‐hospital stay, readmission rates, 90‐day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resect...
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2025-01-01
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| Online Access: | https://doi.org/10.1002/bco2.481 |
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| author | Anas S. Tresh Francesco Del Giudice Shufeng Li Satvir Basran Ettore De Berardinis Dalila Carino Valerio Santarelli Bernardo Rocco Maria Chiara Shighinolfi Roman Mayr Matteo Ferro Riccardo Autorino Gabriele Bignante Felice Crocetto Biagio Barone Renate Pichler José Daniel Subiela Jorge Caño Velasco Marco Moschini Andrea Mari Andrea Gallioli Francesco Soria Simone Albisinni Wojciech Krajewski Jan Łaszkiewicz Łukasz Nowak Tomasz Szydełko Benjamin Challacombe Rajesh Nair Benjamin I. Chung |
| author_facet | Anas S. Tresh Francesco Del Giudice Shufeng Li Satvir Basran Ettore De Berardinis Dalila Carino Valerio Santarelli Bernardo Rocco Maria Chiara Shighinolfi Roman Mayr Matteo Ferro Riccardo Autorino Gabriele Bignante Felice Crocetto Biagio Barone Renate Pichler José Daniel Subiela Jorge Caño Velasco Marco Moschini Andrea Mari Andrea Gallioli Francesco Soria Simone Albisinni Wojciech Krajewski Jan Łaszkiewicz Łukasz Nowak Tomasz Szydełko Benjamin Challacombe Rajesh Nair Benjamin I. Chung |
| author_sort | Anas S. Tresh |
| collection | DOAJ |
| description | Abstract Objectives To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in‐hospital stay, readmission rates, 90‐day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States. Patients and Methods Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de‐identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90‐day complication rates, new postoperative VTE events, re‐hospitalization, and total hospital expenditures (2021 US dollars). Sensitivity analyses on VTE severity (pulmonary embolism [PE], deep venous thrombosis [DVT] or superficial thrombophlebitis/phlebitis [SVT]), as well as TURBT extent (minor vs. major) were additionally examined. Results In total, 139 800 patients were identified, with 5.3% having preoperative VTE, including DVT (n = 3112, 42.20%), PE (n = 2046, 27.74%) and SVT (n = 2217, 30.06%). A history of preoperative VTE predicted higher rates of any complication (adjusted odds ratio [aOR] 1.28, 95% CI 1.14–1.43) and also higher rates of infectious and haemorrhagic complications. Additionally, preoperative VTE increased the risk of novel VTE events following TURBT (aOR 17.30, 95% CI 16.05–18.65), hospital length of stay (aOR 2.23, 95% CI 1.90–2.62), readmissions (aOR 1.47, 95% CI 1.39–1.56), and hospital associated costs (aOR 1.17, 95% CI 1.12–1.23). DVT and non‐minor TURBT procedures did not increase the risk of any, infectious, or haemorrhagic complications, but other associations were maintained regardless of the severity of VTE (PE, DVT, SVT) or TURBT extent (minor/major). Conclusions A history of VTE before undergoing transurethral procedures for BCa is associated with significantly worse perioperative outcomes and higher healthcare costs. These findings may help us to counsel on the risks of the intervention and hopefully improve our ability to mitigate such risks. |
| format | Article |
| id | doaj-art-06d16a8b7339448ca618c7e2173558ef |
| institution | Kabale University |
| issn | 2688-4526 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj-art-06d16a8b7339448ca618c7e2173558ef2025-01-31T00:14:33ZengWileyBJUI Compass2688-45262025-01-0161n/an/a10.1002/bco2.481The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims dataAnas S. Tresh0Francesco Del Giudice1Shufeng Li2Satvir Basran3Ettore De Berardinis4Dalila Carino5Valerio Santarelli6Bernardo Rocco7Maria Chiara Shighinolfi8Roman Mayr9Matteo Ferro10Riccardo Autorino11Gabriele Bignante12Felice Crocetto13Biagio Barone14Renate Pichler15José Daniel Subiela16Jorge Caño Velasco17Marco Moschini18Andrea Mari19Andrea Gallioli20Francesco Soria21Simone Albisinni22Wojciech Krajewski23Jan Łaszkiewicz24Łukasz Nowak25Tomasz Szydełko26Benjamin Challacombe27Rajesh Nair28Benjamin I. Chung29Department of Urology Stanford University School of Medicine Stanford CA USADepartment of Urology Stanford University School of Medicine Stanford CA USADepartment of Urology Stanford University School of Medicine Stanford CA USADepartment of Urology Stanford University School of Medicine Stanford CA USADepartment of Maternal Infant and Urologic Sciences “Sapienza” University of Rome, Policlinico Umberto I Hospital Rome ItalyDepartment of Maternal Infant and Urologic Sciences “Sapienza” University of Rome, Policlinico Umberto I Hospital Rome ItalyDepartment of Maternal Infant and Urologic Sciences “Sapienza” University of Rome, Policlinico Umberto I Hospital Rome ItalyUrologic Unit, ASST Santi Paolo e Carlo La Statale University Milan ItalyUrologic Unit, ASST Santi Paolo e Carlo La Statale University Milan ItalyDepartment of Urology, St. Josef Medical Center University of Regensburg Regensburg GermanyDepartment of Urology European Institute of Oncology (IEO) IRCCS Milan ItalyDepartment of Urology Rush University Medical Center Chicago IL USADepartment of Urology Rush University Medical Center Chicago IL USADepartment of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples Federico II Naples ItalyDepartment of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples Federico II Naples ItalyDepartment of Urology, Comprehensive Cancer Center Innsbruck Medical University of Innsbruck Innsbruck AustriaDepartment of Urology, Hospital Universitario Ramón y Cajal, IRYCIS Universidad de Alcala Madrid SpainDepartment of Urology Gregorio Marañón University Hospital Madrid SpainDivision of Experimental Oncology, Unit of Urology IRCCS Ospedale San Raffaele Milan ItalyUrological Robotic Surgery and Renal Transplantation Unit, Careggi Hospital University of Florence Florence ItalyDepartment of Urology, Fundació Puigvert Universitat Autonoma de Barcelona Barcelona SpainDivision of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital University of Studies of Torino Turin ItalyUnit of Urology, Department of Surgical Sciences Tor Vergata University Rome ItalyUniversity Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wroclaw PolandUniversity Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wroclaw PolandUniversity Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wroclaw PolandUniversity Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wroclaw PolandGuy's and St. Thomas' NHS Foundation Trust Guys and St Thomas' Hospital London UKGuy's and St. Thomas' NHS Foundation Trust Guys and St Thomas' Hospital London UKDepartment of Urology Stanford University School of Medicine Stanford CA USAAbstract Objectives To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in‐hospital stay, readmission rates, 90‐day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States. Patients and Methods Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de‐identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90‐day complication rates, new postoperative VTE events, re‐hospitalization, and total hospital expenditures (2021 US dollars). Sensitivity analyses on VTE severity (pulmonary embolism [PE], deep venous thrombosis [DVT] or superficial thrombophlebitis/phlebitis [SVT]), as well as TURBT extent (minor vs. major) were additionally examined. Results In total, 139 800 patients were identified, with 5.3% having preoperative VTE, including DVT (n = 3112, 42.20%), PE (n = 2046, 27.74%) and SVT (n = 2217, 30.06%). A history of preoperative VTE predicted higher rates of any complication (adjusted odds ratio [aOR] 1.28, 95% CI 1.14–1.43) and also higher rates of infectious and haemorrhagic complications. Additionally, preoperative VTE increased the risk of novel VTE events following TURBT (aOR 17.30, 95% CI 16.05–18.65), hospital length of stay (aOR 2.23, 95% CI 1.90–2.62), readmissions (aOR 1.47, 95% CI 1.39–1.56), and hospital associated costs (aOR 1.17, 95% CI 1.12–1.23). DVT and non‐minor TURBT procedures did not increase the risk of any, infectious, or haemorrhagic complications, but other associations were maintained regardless of the severity of VTE (PE, DVT, SVT) or TURBT extent (minor/major). Conclusions A history of VTE before undergoing transurethral procedures for BCa is associated with significantly worse perioperative outcomes and higher healthcare costs. These findings may help us to counsel on the risks of the intervention and hopefully improve our ability to mitigate such risks.https://doi.org/10.1002/bco2.481bladder cancerdeep venous thrombosishealth‐related costsperioperative morbiditypulmonary embolismTURBT |
| spellingShingle | Anas S. Tresh Francesco Del Giudice Shufeng Li Satvir Basran Ettore De Berardinis Dalila Carino Valerio Santarelli Bernardo Rocco Maria Chiara Shighinolfi Roman Mayr Matteo Ferro Riccardo Autorino Gabriele Bignante Felice Crocetto Biagio Barone Renate Pichler José Daniel Subiela Jorge Caño Velasco Marco Moschini Andrea Mari Andrea Gallioli Francesco Soria Simone Albisinni Wojciech Krajewski Jan Łaszkiewicz Łukasz Nowak Tomasz Szydełko Benjamin Challacombe Rajesh Nair Benjamin I. Chung The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data BJUI Compass bladder cancer deep venous thrombosis health‐related costs perioperative morbidity pulmonary embolism TURBT |
| title | The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data |
| title_full | The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data |
| title_fullStr | The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data |
| title_full_unstemmed | The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data |
| title_short | The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data |
| title_sort | impact of preoperative venous thromboembolism on patients undergoing turbt perioperative outcomes and healthcare costs from us insurance claims data |
| topic | bladder cancer deep venous thrombosis health‐related costs perioperative morbidity pulmonary embolism TURBT |
| url | https://doi.org/10.1002/bco2.481 |
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