Do certain factors predict the development of blood clots after prostate surgery?

The authors aimed to identify factors associated with an increased risk of blood clot development following radical prostatectomy.

The formation of blood clots in the veins is the most common non-operative complication after radical prostatectomy (surgical removal of the prostate). While effective preventative therapies exist, they are also associated with increased complications. While large studies suggest the incidence of blood clots following surgery to be 2.9 – 3.9%, the studies include limited information for identifying individual risk factors.

The authors wanted to identify factors associated with increased risks of blood clots following radical prostatectomy and pelvic lymphadenectomy (surgery to remove the lymph nodes in the pelvis for examination under the microscope).

Of 18,472 patients treated with radical prostatectomy, 1.47% experienced a symptomatic blood clot within 30 days of surgery in the deep veins (not close to the skin), in the lungs, or in both. 3% of those with a blood clot died within 30 days compared to 0% of those without blood clots.

Compared to those undergoing traditional prostatectomy, those who underwent robot-assisted prostatectomy showed a trend towards lower incidence of blood clots.

Patients with a non-O blood type were 87% more likely to be diagnosed with a blood clot compared to patients with O blood type. An increased number of lymph nodes removed during surgery was also associated with an increased likelihood of blood clot development. Also, 21.5% of those who were diagnosed with a blood clot had received a previous blood transfusion compared to 15.8% of those who had not.

The authors suggested that the risk factors outlined in the study be taken into account when administering preventative therapy for blood clots prior to surgery in prostate cancer.