The preoperative use of erythropoietin stimulating proteins prior to radical prostatectomy is not associated with increased cardiovascular or thromboembolic morbidity or mortality.
OBJECTIVE
To critically examine the cardiovascular and thromboembolic risks associated with erythropoietin stimulating proteins (ESPs) in men with normal hemoglobin levels undergoing open radical retropubic prostatectomy.


METHODS
Between October 1, 2000, through December 31, 2006, a total of 1308 men underwent open radial retropubic prostatectomy by a single surgeon. Of these men, 1095 received preoperative ESPs. Hematocrit levels measured at baseline, immediately before anesthesia induction and at hospital discharge, were prospectively entered into a database. Thromboembolic and cardiovascular complications were prospectively captured during the hospitalization and after surgery.


RESULTS
The mean Delta preoperative hematocrit level was 5.9 g/dL. The pre-anesthesia induction hematocrit level was 49.2%. Hospital discharge hematocrit level was 33.6 g/dL. The overall risk of cardiovascular and thromboembolic complications in men receiving ESP were 0.55% and 0.45%, respectively. The risk of cardiovascular and thromboembolic complications were independent of the Delta in preoperative hematocrit or the absolute level of the pre-anesthesia induction hematocrit.


CONCLUSIONS
ESPs represent a safe and effective preoperative blood management strategy for men undergoing open radical retropubic prostatectomy.
Lepor
Herbert
H
Department of Urology, New York University School of Medicine, New York, New York 10016, USA. herbert.lepor@nyumc.org
Lipkin
Michael
M
Slova
Denisa
D
D000368:Aged; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D015331:Cohort Studies; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006400:Hematocrit; D006454:Hemoglobins / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods* / Q000401:mortality; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery*; D011994:Recombinant Proteins; D018570:Risk Assessment; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D016896:Treatment Outcome
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin