HEmaturia After Transurethral resection of bladder Tumour (HEATT) - a multicentre, regional, collaborative analysis of factors associated with emergency re-admission with haematuria following TURBT
BAUS ePoster online library. Sarmah P. 06/21/21; 319124; p8-6
Disclosure(s): None to declare
Mr. Piyush Sarmah
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Abstract
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Introduction
Many patients undergoing transurethral resection of bladder tumour (TURBT) for bladder cancer possess significant co-morbidities, including prescription of antithrombotic agents (ATAs). The aim of this study was to identify the risk of post-operative haematuria with such drugs.
Methods
This was a multicentre, retrospective audit. All adult patients over the age of 16 who underwent elective TURBT between 1st September – 30th November 2019 were identified. Data was collected from medical records and operation notes on patient demographics including ATAs and peri-operative management. Primary outcomes were re-admission and re-operation rates for haematuria within 30 days of TURBT. Secondary outcome was acute thrombotic event (TE) within 30 days post-operatively.
Results
443 patients from 10 centres were included. Median age was 75 years (range 17-99). 147 patients (33.2%) were on pre-existing ATAs (86 excluding Aspirin). 15 patients (3.4%) overall were re-admitted with haematuria within 30 days of TURBT. Subgroup analysis demonstrated higher rate of re-admission for pre-existing ATAs (2.0% vs 6.1%, Fisher exact test p=0.046), increased for non-Aspirin ATAs (10.5%, Fisher exact test p=0.0015). 52% of non-Aspirin ATAs were restarted within 48 hours of surgery; post-operative plan for restarting was not documented in 22.1%.
No patient re-admitted with haematuria required a further operation to resolve this, although 1 patient did so during their index admission. 1 patient (0023%) developed an acute TE (pulmonary embolus) within 30 days of TURBT.
Conclusions
Pre-existing use of non-Aspirin ATAs is associated with an increased risk of haematuria following TURBT, with variable practice in restarting these post-operatively.
Many patients undergoing transurethral resection of bladder tumour (TURBT) for bladder cancer possess significant co-morbidities, including prescription of antithrombotic agents (ATAs). The aim of this study was to identify the risk of post-operative haematuria with such drugs.
Methods
This was a multicentre, retrospective audit. All adult patients over the age of 16 who underwent elective TURBT between 1st September – 30th November 2019 were identified. Data was collected from medical records and operation notes on patient demographics including ATAs and peri-operative management. Primary outcomes were re-admission and re-operation rates for haematuria within 30 days of TURBT. Secondary outcome was acute thrombotic event (TE) within 30 days post-operatively.
Results
443 patients from 10 centres were included. Median age was 75 years (range 17-99). 147 patients (33.2%) were on pre-existing ATAs (86 excluding Aspirin). 15 patients (3.4%) overall were re-admitted with haematuria within 30 days of TURBT. Subgroup analysis demonstrated higher rate of re-admission for pre-existing ATAs (2.0% vs 6.1%, Fisher exact test p=0.046), increased for non-Aspirin ATAs (10.5%, Fisher exact test p=0.0015). 52% of non-Aspirin ATAs were restarted within 48 hours of surgery; post-operative plan for restarting was not documented in 22.1%.
No patient re-admitted with haematuria required a further operation to resolve this, although 1 patient did so during their index admission. 1 patient (0023%) developed an acute TE (pulmonary embolus) within 30 days of TURBT.
Conclusions
Pre-existing use of non-Aspirin ATAs is associated with an increased risk of haematuria following TURBT, with variable practice in restarting these post-operatively.
Introduction
Many patients undergoing transurethral resection of bladder tumour (TURBT) for bladder cancer possess significant co-morbidities, including prescription of antithrombotic agents (ATAs). The aim of this study was to identify the risk of post-operative haematuria with such drugs.
Methods
This was a multicentre, retrospective audit. All adult patients over the age of 16 who underwent elective TURBT between 1st September – 30th November 2019 were identified. Data was collected from medical records and operation notes on patient demographics including ATAs and peri-operative management. Primary outcomes were re-admission and re-operation rates for haematuria within 30 days of TURBT. Secondary outcome was acute thrombotic event (TE) within 30 days post-operatively.
Results
443 patients from 10 centres were included. Median age was 75 years (range 17-99). 147 patients (33.2%) were on pre-existing ATAs (86 excluding Aspirin). 15 patients (3.4%) overall were re-admitted with haematuria within 30 days of TURBT. Subgroup analysis demonstrated higher rate of re-admission for pre-existing ATAs (2.0% vs 6.1%, Fisher exact test p=0.046), increased for non-Aspirin ATAs (10.5%, Fisher exact test p=0.0015). 52% of non-Aspirin ATAs were restarted within 48 hours of surgery; post-operative plan for restarting was not documented in 22.1%.
No patient re-admitted with haematuria required a further operation to resolve this, although 1 patient did so during their index admission. 1 patient (0023%) developed an acute TE (pulmonary embolus) within 30 days of TURBT.
Conclusions
Pre-existing use of non-Aspirin ATAs is associated with an increased risk of haematuria following TURBT, with variable practice in restarting these post-operatively.
Many patients undergoing transurethral resection of bladder tumour (TURBT) for bladder cancer possess significant co-morbidities, including prescription of antithrombotic agents (ATAs). The aim of this study was to identify the risk of post-operative haematuria with such drugs.
Methods
This was a multicentre, retrospective audit. All adult patients over the age of 16 who underwent elective TURBT between 1st September – 30th November 2019 were identified. Data was collected from medical records and operation notes on patient demographics including ATAs and peri-operative management. Primary outcomes were re-admission and re-operation rates for haematuria within 30 days of TURBT. Secondary outcome was acute thrombotic event (TE) within 30 days post-operatively.
Results
443 patients from 10 centres were included. Median age was 75 years (range 17-99). 147 patients (33.2%) were on pre-existing ATAs (86 excluding Aspirin). 15 patients (3.4%) overall were re-admitted with haematuria within 30 days of TURBT. Subgroup analysis demonstrated higher rate of re-admission for pre-existing ATAs (2.0% vs 6.1%, Fisher exact test p=0.046), increased for non-Aspirin ATAs (10.5%, Fisher exact test p=0.0015). 52% of non-Aspirin ATAs were restarted within 48 hours of surgery; post-operative plan for restarting was not documented in 22.1%.
No patient re-admitted with haematuria required a further operation to resolve this, although 1 patient did so during their index admission. 1 patient (0023%) developed an acute TE (pulmonary embolus) within 30 days of TURBT.
Conclusions
Pre-existing use of non-Aspirin ATAs is associated with an increased risk of haematuria following TURBT, with variable practice in restarting these post-operatively.
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