title: Influence of antiplatelet-anticoagulant drugs on the need of blood components transfusion after vesical transurethral resection.
abstract: OBJECTIVE
  The effect of the antithrombotic preventive therapy on haemorrhage keeps uncertain. We investigate the influence of the antiplatelet and anticoagulant drugs (AP/AC drugs) on the transfusion requirement after vesical transurethral resection (VTUR). We also describe the epidemiology of the blood components transfusion in our department.
  
  
  METHODS
  Retrospective observational study of a series of patients needing blood transfusion at the Urology Department between June 2010 and June 2013. Selection of 100 consecutive patients who were transfused after VTUR due to bladder transitional cell carcinoma (BTCC) (group A = GA).
  
  
  METHODS
  100 consecutive patients who underwent VTUR due to BTCC and were not transfused (group B = GB). Transfusion criteria: Haemoglobin &lt; 8 g/dl + anaemia symptoms. Age, gender, associated AP/AC treatment, secondary diagnoses, toxics, tumour stage and grade were analysed.
  
  
  RESULTS
  212 patients required transfusion of a blood component. 169 were men (79%) and 43 women (21%). Median age 77.59 years (SD 9.42, range 50-92). Secondary diagnoses: Diabetes Mellitus 64%, high blood pressure 77%, dyslipidemia 52%. 60% of patients were previously treated with AP/AC drugs. Average Haemoglobin pre-transfusion values: 7.4 g/dl (DE ± 0.7). Average Haemoglobin post-transfusion values: 8.9 g/Dl (DE ± 0.72). Most frequent transfusion indications were bladder cancer (37%), kidney cancer (11%), prostate cancer (8%), benign prostatic hyperplasia (BHP) (8%), other urological diagnoses (36%). Intraoperative transfusions indicated by the anaesthesiologist: kidney cancer (33%), BPH (28%). Patients who underwent VTUR due to BTCC were older in GA (77.59 years SD 9.42) than in GB (68.98 years SD 11.78) (p = 0.0001). Similar gender distribution (15 women in GA and 24 in GB). Less patients were asked to keep their treatment with ASA 100mg (AcetylSalicylicAcid) in GA (25.64%) than in GB (50%) (p = 0.0330). More aggressive tumour grade in GA (p = 0.0003) and higher stage in GA (p = 0.0018) regardless of concomitant treatment with AP/AC drugs.
  
  
  CONCLUSIONS
  The pathologies which most needed blood components' transfusions in the Urology Department were (in order of frequency): bladder cancer, kidney cancer, prostate cancer, prostate adenoma. ASA100mg did not influence the transfusion's requirements in VTUR due to BTCC. Tumour stage and higher grade have a greater influence in transfusion's requirements than concomitant AP/AC treatment. The heterogeneity of AP/AC protocols does not allow to establish the benefit of stopping those drugs before surgery in terms of avoiding blood transfusions when performing a VTUR.
authors.affiliation: Department of Urology, University Hospital of Salamanca. mflorenzogo@yahoo.es.
authors.forename: Alvaro Julio
authors.initials: AJ
authors.lastname: Virseda-Rodríguez
authors.forename: Barbara
authors.initials: B
authors.lastname: Padilla-Fernández
authors.forename: Mirian
authors.initials: M
authors.lastname: López-Parra
authors.forename: Maria Tatiana
authors.initials: MT
authors.lastname: Santos-Antunes
authors.forename: Lauro Sebastian
authors.initials: LS
authors.lastname: Valverde-Martínez
authors.forename: Maria Jesus
authors.initials: MJ
authors.lastname: Nieto-González
authors.forename: Jesus Fernando
authors.initials: JF
authors.lastname: San Miguel-Izquierdo
authors.forename: Anabel
authors.initials: A
authors.lastname: Lorenzo-Gómez
authors.forename: Maria Begoña
authors.initials: MB
authors.lastname: García-Cenador
authors.forename: Patricia
authors.initials: P
authors.lastname: Antúnez-Plaza
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lorenzo-Gómez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001803:Blood Transfusion; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors