title: Blood type, lymphadenectomy and blood transfusion predict venous thromboembolic events following radical prostatectomy with pelvic lymphadenectomy.
abstract: OBJECTIVE
  Venous thromboembolic events are the most common nonoperative complication after radical prostatectomy and they represent the most common cause of death within 30 days of surgery. While effective mechanical and chemoprophylaxis exists, such prophylaxis may also be associated with increased complications. To identify venous thromboembolic event risk factors and, thereby, facilitate targeted prophylaxis we characterized clinicopathological variables associated with these events in patients undergoing radical prostatectomy.
  
  
  METHODS
  We reviewed the records of 18,472 consecutive patients who underwent radical prostatectomy with pelvic lymphadenectomy for prostate cancer at our institution from 1987 to 2010. Patients were followed postoperatively for complications. Venous thromboembolic events within 30 days of surgery were recorded. Logistic regression models were used to analyze clinicopathological variables associated with venous thromboembolic events.
  
  
  RESULTS
  We identified symptomatic venous thromboembolic events in 271 patients (1.4%). This diagnosis was not associated with preoperative body mass index, prostate specific antigen, Gleason score or cancer recurrence. However, the diagnosis was significantly associated with nonO blood type (OR 1.98, p = 0.004), an increasing number of lymph nodes removed (OR 1.05, p = 0.035) and blood transfusion (OR 1.30, p = 0.02). Patients with venous thromboembolic events were significantly more likely to die within 30 days of surgery (3.0% vs 0%, p <0.001).
  
  
  CONCLUSIONS
  Blood type, pelvic lymphadenectomy extent and blood transfusion are significant risk factors for symptomatic venous thromboembolic event before radical prostatectomy plus pelvic lymph node dissection. These data should be used for patient counseling, particularly in regard to obviating lymphadenectomy in patients at low risk and for individualizing prophylaxis for venous thromboembolic event in patients at higher risk.
authors.affiliation: Departments of Urology and Health Sciences Research (LR, RC), Mayo Medical School and Mayo Clinic, Rochester, Minnesota. Electronic address: tollefson.matthew@mayo.edu.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.affiliation: Departments of Urology and Health Sciences Research (LR, RC), Mayo Medical School and Mayo Clinic, Rochester, Minnesota.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.affiliation: Departments of Urology and Health Sciences Research (LR, RC), Mayo Medical School and Mayo Clinic, Rochester, Minnesota.
authors.forename: Laureano
authors.initials: L
authors.lastname: Rangel
authors.affiliation: Departments of Urology and Health Sciences Research (LR, RC), Mayo Medical School and Mayo Clinic, Rochester, Minnesota.
authors.forename: Rachel
authors.initials: R
authors.lastname: Carlson
authors.affiliation: Departments of Urology and Health Sciences Research (LR, RC), Mayo Medical School and Mayo Clinic, Rochester, Minnesota.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boorjian
mesh_terms: D001788:Blood Grouping and Crossmatching; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D054556:Venous Thromboembolism / Q000453:epidemiology*
keywords: ABO blood-group system; prostate; prostatectomy; prostatic neoplasms; venous thromboembolism