Is the widespread use of anticoagulation and antiplatelets causing avoidable postoperative bleeding in Urology patients necessitating additional hospital visits?
BAUS ePoster online library. Phillips E. 11/10/20; 304243; P8-3
Emily Phillips
Emily Phillips
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Abstract
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Is the widespread use of anticoagulation and antiplatelets causing avoidable postoperative bleeding in Urology patients necessitating additional hospital visits?

Phillips E1, Yao M1, Folkard S1, Rajagopalan A1, Varga B1, Kommu S1, Shotri N1
1Kent and Canterbury Hospital, United Kingdom

Introduction:
Post procedural haematuria is responsible for a significant number of attendances and readmissions to the Emergency Department (ED) and portends a potentially avoidable health burden. A significant number of patients undergoing urological procedures are on anticoagulants and/or antiplatelet medications. Herein, we aim to identify whether prior use of these medications impact on post procedural haematuria.

Methods:
Patient episodes over a one-year period between 01/10/18 and 30/09/19 were interrogated. Inclusion criteria were age 60 or over, elective urological procedure, and ED attendance with a coded diagnosis of haematuria within 30 days of the original procedure. Readmission rates were tallied and analysed.

Results:
131 episodes fulfilled the inclusion criteria, reflecting 70 different patients. Of these, 75 (57%) were readmissions and 56 (43%) ED attendances; overall 96 (73%) were anticoagulated. The most common procedure leading to ED attendance and/or readmission were bladder biopsies (57 cases) of which 74% were anticoagulated. Rivaroxaban (n=21 cases) and Aspirin (n=20 cases) were the most commonly used anticoagulant and antiplatelet agents respectively. The odds ratio for ED attendance following an elective urological procedure on anticoagulation was 2.11, and for readmission with haematuria 3.41 compared to patients not anticoagulated.

Conclusion:
Patients on anticoagulation and antiplatelet agents are more likely to be readmitted with haematuria. Adequate counselling of these patients preoperatively and careful timing of restarting anticoagulation, whilst balancing their risks versus benefits, can reduce attendances and/or readmissions via the ED.
Is the widespread use of anticoagulation and antiplatelets causing avoidable postoperative bleeding in Urology patients necessitating additional hospital visits?

Phillips E1, Yao M1, Folkard S1, Rajagopalan A1, Varga B1, Kommu S1, Shotri N1
1Kent and Canterbury Hospital, United Kingdom

Introduction:
Post procedural haematuria is responsible for a significant number of attendances and readmissions to the Emergency Department (ED) and portends a potentially avoidable health burden. A significant number of patients undergoing urological procedures are on anticoagulants and/or antiplatelet medications. Herein, we aim to identify whether prior use of these medications impact on post procedural haematuria.

Methods:
Patient episodes over a one-year period between 01/10/18 and 30/09/19 were interrogated. Inclusion criteria were age 60 or over, elective urological procedure, and ED attendance with a coded diagnosis of haematuria within 30 days of the original procedure. Readmission rates were tallied and analysed.

Results:
131 episodes fulfilled the inclusion criteria, reflecting 70 different patients. Of these, 75 (57%) were readmissions and 56 (43%) ED attendances; overall 96 (73%) were anticoagulated. The most common procedure leading to ED attendance and/or readmission were bladder biopsies (57 cases) of which 74% were anticoagulated. Rivaroxaban (n=21 cases) and Aspirin (n=20 cases) were the most commonly used anticoagulant and antiplatelet agents respectively. The odds ratio for ED attendance following an elective urological procedure on anticoagulation was 2.11, and for readmission with haematuria 3.41 compared to patients not anticoagulated.

Conclusion:
Patients on anticoagulation and antiplatelet agents are more likely to be readmitted with haematuria. Adequate counselling of these patients preoperatively and careful timing of restarting anticoagulation, whilst balancing their risks versus benefits, can reduce attendances and/or readmissions via the ED.
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