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    • The Impact of Venous Thromboembolism on Bladder Cancer Patients Undergoing Open or Minimally-Invasive Radical Cystectomy in the United States: Perioperative Outcomes and Health-Care Costs from Insurance Claims Data

    F. Del Giudice,A. Tresh,S. Basran,F. Belladelli,E. De Berardinis,V Asero,C. M. Scornajenghi, D. Carino,M. Ferro,G. M. Busetto,F. Crocetto,R. Balsamo,B. Barone,B. Pradere,W. Krajewski,L. Nowak,T. Szydelko,M. Moschini,A. Mari,A. Rane,B. Challacombe,R. Nair,B. Chung

    The Journal of Urology（2024）

    Sapienza Univ Rome | Stanford Univ | IRCCS | Univ Foggia | Univ Naples Federico II | Colli Monaldi Hosp | Med Univ Vienna | Wroclaw Med Univ | 4th Clin Mil Hosp | Univ Florence | East Surrey Hosp | Guys & St Thomas Hosp

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    Abstract
    You have accessJournal of UrologyBladder Cancer: Invasive I (PD02)1 May 2024PD02-05 THE IMPACT OF VENOUS THROMBOEMBOLISM ON MUSCLE INVASIVE BLADDER CANCER (MIBC) PATIENTS UNDERGOING OPEN OR MINIMALLY-INVASIVE RADICAL CYSTECTOMY IN THE UNITED STATES: PERIOPERATIVE OUTCOMES AND HEALTH-CARE COSTS FROM INSURANCE CLAIMS DATA Francesco Del Giudice, Anas Tresh, Ettore De Berardinis, Vincenzo Asero, Carlo Maria Scornajenghi, Satvir Basran, Federico Belladelli, Gian Maria Busetto, Matteo Ferro, Felice Crocetto, Biagio Barone, Benjamin Pradere, Wojciech Krajewski, Lukasz Nowak, Marco Moschini, Abhay Rane, Ben Challacombe, Rajesh Nair, and Benjamin I. Chung Francesco Del GiudiceFrancesco Del Giudice , Anas TreshAnas Tresh , Ettore De BerardinisEttore De Berardinis , Vincenzo AseroVincenzo Asero , Carlo Maria ScornajenghiCarlo Maria Scornajenghi , Satvir BasranSatvir Basran , Federico BelladelliFederico Belladelli , Gian Maria BusettoGian Maria Busetto , Matteo FerroMatteo Ferro , Felice CrocettoFelice Crocetto , Biagio BaroneBiagio Barone , Benjamin PradereBenjamin Pradere , Wojciech KrajewskiWojciech Krajewski , Lukasz NowakLukasz Nowak , Marco MoschiniMarco Moschini , Abhay RaneAbhay Rane , Ben ChallacombeBen Challacombe , Rajesh NairRajesh Nair , and Benjamin I. ChungBenjamin I. Chung View All Author Informationhttps://doi.org/10.1097/01.JU.0001008836.73392.92.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interplay between Venous Thromboembolism (VTE) and solid malignancy is established. With rising projected rates of bladder cancer (BCa) and increasing number of patients experiencing BCa and VTE, our aim is to assess the impact of a preoperative VTE diagnosis on perioperative outcomes and health-care costs in MIBC undergoing Radical Cystectomy (RC). METHODS: Patients≥18 y/o with BCa undergoing Open or Minimally Invasive (MIS) RC were identified in the MerativeTM Marketscan® Research Databases between 2007 and 2021. The association of VTE history with 90-day complication rates, postoperative VTE events, rehospitalization, and total hospital costs (2021 US dollars) was determined by multivariable logistic regression modeling adjusted for patient and perioperative confounders. Sensitivity analysis on VTE degree of severity (i.e., pulmonary embolism [PE] and/or peripheral deep [DVT] or superficial venous thrombosis) was examined. RESULTS: Out of n=8,759 RC procedures, n=743 (8.48%) had a previous history for any VTE including n=245 (32.97%) PE, n=339 (45.63%) DVT and n=59 (21.40%) superficial VTE. Overall, history of VTE before RC was strongly associated with almost any worse postoperative outcomes including higher risk for any and apparatus-specific 90-days postoperative complications (Odds Ratio [OR]: 1.23, 95% Confidence Interval [CI], 1.03-1.46). Subsequent incidence of new VTE events (OR: 7.02, 95% CI: 5.93-8.31), rehospitalization (OR: 1.25, 95% CI: 1.06-1.48), other than home/self-care discharge status (OR: 1.53, 95% CI: 1.28-1.82), and higher health-care costs related to the RC procedure (OR: 1.43, 95% CI: 1.22-1.68) were significantly correlated with VTE history. Importantly, the association was maintained regardless the severity of VTE history (i.e., PE, DVT or phlebitis/thrombophlebitis). CONCLUSIONS: Experiencing VTE before RC for MIBC significantly raises the risk of any worse perioperative outcomes regardless the severity of the VTE event. These findings will likely have an impact in BCa counseling on the risks of surgery and will improve our ability to mitigate such risks. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e71 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francesco Del Giudice More articles by this author Anas Tresh More articles by this author Ettore De Berardinis More articles by this author Vincenzo Asero More articles by this author Carlo Maria Scornajenghi More articles by this author Satvir Basran More articles by this author Federico Belladelli More articles by this author Gian Maria Busetto More articles by this author Matteo Ferro More articles by this author Felice Crocetto More articles by this author Biagio Barone More articles by this author Benjamin Pradere More articles by this author Wojciech Krajewski More articles by this author Lukasz Nowak More articles by this author Marco Moschini More articles by this author Abhay Rane More articles by this author Ben Challacombe More articles by this author Rajesh Nair More articles by this author Benjamin I. Chung More articles by this author Expand All Advertisement PDF downloadLoading ...
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    Venous Thromboembolism,Postoperative Complications,Cardiovascular Evaluation,Deep Vein Thrombosis
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    【要点】：本研究评估了术前静脉血栓栓塞（VTE）诊断对肌层浸润性膀胱癌（MIBC）患者行开放性或微创根治性膀胱切除术（RC）围术期结果和医疗保健成本的影响，发现VTE病史与较差的围术期结果和更高的医疗保健成本显著相关。
    

    【方法】：利用2007年至2021年MerativeTM Marketscan®研究数据库中的数据，对≥18岁的膀胱癌患者进行开放性或微创RC手术，通过多变量逻辑回归模型分析VTE病史与围术期结果及医疗保健成本的关系。
    

    【实验】：共8759例RC手术，其中743例（8.48%）有VTE病史。研究显示，术前VTE病史与术后90天并发症风险增加、新发VTE事件、再住院率、非居家/自我照顾出院状态和RC手术相关医疗保健成本增加显著相关。这一相关性在VTE病史的不同严重程度（即肺栓塞、深静脉血栓形成或浅表静脉血栓形成）下均保持一致。