Influence of antiplatelet-anticoagulant drugs on the need of blood components transfusion after vesical transurethral resection

  • Alvaro Julio Virseda-Rodríguez Department of Urology, University Hospital of Salamanca, Spain.
  • Barbara Padilla-Fernández Department of Urology, University Hospital of the Canary Islands (Tenerife), Spain.
  • Mirian López-Parra Department of Haematology, University Hospital of Salamanca, Spain.
  • Maria Tatiana Santos-Antunes Department of Surgery, University of Salamanca, Spain.
  • Lauro Sebastian Valverde-Martínez Department of Urology, University Hospital of Salamanca, Spain.
  • Maria Jesus Nieto-González Department of Haematology, University Hospital of Salamanca, Spain.
  • Jesus Fernando San Miguel-Izquierdo Clinical and Translational Medicine of the University of Navarra, Spain.
  • Anabel Lorenzo-Gómez Department of Surgery, University of Salamanca, Spain.
  • Maria Begoña García-Cenador Department of Surgery, University of Salamanca, Spain.
  • Patricia Antúnez-Plaza Department of Pathology, University Hospital of Salamanca, Spain.
  • Maria Fernanda Lorenzo-Gómez | mflorenzogo@yahoo.es Department of Urology, University Hospital of Salamanca; Department of Surgery, University of Salamanca, Spain.

Abstract

Aims: 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. Materials and 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). Control group: 100 consecutive patients who underwent VTUR due to BTCC and were not transfused (group B = GB). Transfusion criteria: Haemoglobin < 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.

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Published
2015-07-07
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Section
Original Papers - Incontinence & Urodynamics
Keywords:
Transurethral resection, Bladder transitional carcinoma, Blood transfusion
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How to Cite
Virseda-Rodríguez, A., Padilla-Fernández, B., López-Parra, M., Santos-Antunes, M., Valverde-Martínez, L., Nieto-González, M., San Miguel-Izquierdo, J., Lorenzo-Gómez, A., García-Cenador, M., Antúnez-Plaza, P., & Lorenzo-Gómez, M. (2015). Influence of antiplatelet-anticoagulant drugs on the need of blood components transfusion after vesical transurethral resection. Archivio Italiano Di Urologia E Andrologia, 87(2), 136-140. https://doi.org/10.4081/aiua.2015.2.136

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