title: Hospital Episode Statistics data analysis of postoperative venous thromboembolus in patients undergoing urological surgery: a review of 126,891 cases.
abstract: BACKGROUND
  Current guidelines on venous thromboembolism (VTE) prevention do not reflect the potential varying risk for patients undergoing different urological procedures. Our study aimed to establish the procedure specific rate of postoperative VTE in patients undergoing urological  surgery.
  
  
  METHODS
  Hospital Episode Statistics were obtained for all patients undergoing common urological procedures between April 2009 and April 2010. This cohort was followed up to identify all patients reattending with either deep vein thrombosis (DVT) or pulmonary embolism (PE) within  12 months.
  
  
  RESULTS
  A total of 126,891 individuals underwent urological surgery during the study period. This included 89,628 men (70.6%) and 37,236 women (29.3%) with a mean age of 65.2 years. At the 12-month follow-up, 839 patients (0.66%) were readmitted with VTE. Of these, 373 (0.29%)  were admitted with DVT and 466 (0.37%) with PE. The procedure-specific rate of VTE varied significantly between 2.86% following cystectomy and 0.23% following urethral dilatation. Procedures performed in the lithotomy position carried a significantly lower risk of VTE than those performed  in the supine position (0.60% vs 1.28%, p <0.0001). Furthermore, of all procedures performed in the lithotomy position, those performed on benign conditions carried a significantly lower risk than those performed on malignant disease (0.52% vs 0.79%, p <0.0001).
  
  
  CONCLUSIONS
  Procedure specific rates of postoperative VTE vary widely among patients undergoing urological procedures. These findings suggest the potential benefit of prolonging the use of thromboprophylaxis in high-risk patients but also exploring the apparent lack of need for routine thromboprophylaxis  in patients undergoing low-risk procedures.
authors: Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK. james.dyer@nhs.net
authors: J
authors: J
authors: Dyer
authors: S
authors: S
authors: Wyke
authors: C
authors: C
authors: Lynch
mesh_terms: D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D056888:Patient Positioning / Q000009:adverse effects / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D054556:Venous Thromboembolism / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology*