Login to Access Video or Poster Abstract: MP47-17
Sources of Funding: None

Introduction

Postoperative venous thromboembolism (VTE) is associated with significant morbidity and mortality. VTE rates after radical prostatectomy range from 0.3% to 3.9% in the recent literature. Caprini and colleagues developed a model to identify surgical patients at greater risk for VTE. The Caprini score has been validated in high risk, reconstructive, and plastic surgery patients. We assessed the validity of this score as a predictor of VTE in patients undergoing robotic assisted laparoscopic prostatectomy.

Methods

We retrospectively reviewed our IRB-approved database and identified patients who developed VTE after robotic prostatectomy between December 2003 and February 2016. Non-VTE cases immediately preceding and immediately following each index VTE case were used as controls, accounting for surgeon and lymphadenectomy. The Caprini score and the Charlson Comorbidity Index (CCI) were calculated and basic clinical parameters were extracted. Analyses comparing the VTE and no VTE groups were performed using Wilcoxon Ranked Sum and Chi-Square tests of Proportion. Multivariate logistic regression and ROC curves were used to predict VTE. SPSSv21 and a significance level of .05 were used for all analyses.

Results

3719 patients underwent robotic prostatectomy during the study period; 52 VTE (1.4%) cases were identified and 97 controls were selected. No significant differences in PSA, Gleason score, or stage were observed between the two groups; significant differences were observed in overall OR times but not in time on the robot (Table 1). The Caprini score was significantly higher for the VTE group. Caprini score (OR = 1.93; p=.002) and OR time (OR = 1.01; p=.007) were independently significant predictors of VTE on multivariate analysis. ROC analyses identified a Caprini score of 6 and an OR time of 3.4 hours as the predictive cut-points for VTE (AUC = .64, p = .004; AUC = .63, p=.01 respectively).

Conclusions

Tools are needed to identify patients at higher risk of VTE and protocols are needed to lower risk. Our data support the use of the Caprini score as a risk assessment tool in the prediction of postoperative VTE in patients undergoing robotic prostatectomy.

Funding

None