Use of Thromboprophylaxis in Renal Surgery in the Nordic Countries

• Main Authors: Brøchner Pedersen, Torben, Møller Jeppesen, Sune, Sundqvist, Pernilla, Nisen, Harry, Nilsen, Frode, Gudmundsson, Eiríkur Orri, Lund, Lars
• Format: Conference Object
• Language: Danish
• Published: 2019
• Subjects: Thromboembolism; Surgery; Kidney Neoplasms; Norway; Iceland
• Online Access: https://portal.findresearcher.sdu.dk/da/publications/2745d777-ab16-46fe-a626-173287b91051

Introduction High quality evidence for the use of thromboprophylaxis in renal urological surgery has been lacking. In 2017 a work panel under the European Association of Urology (EAU) published the first comprehensive guideline specific to urological surgery. The guideline offers practical evidence based guidance on use of thromboproprophylaxis. Prior to this guideline publication, a previous questionaire (The NoRenCa-2 study) suggested a high degree of variation in thromboprophylaxis practice in renal surgery across the nordic countries. As a follow-up to this study we sought to examine the current practice at different urological departments accross the nordic region. Materials and method A 16 question internet based questionaire was distrubuted by e-mail to nordic urological departments performing renal surgery. The questionnaire addressed familiarity with a selection of current guidelines (The American College of Chest Physicians (AACP), The National Institute for Health and Care Excellence (NICE), EAU, local and national guidelines) and thromboprophylaxis for specific renal surgical procedures. Results A total 85 sites were invited to complete the questionarie, with a reponse rate of 45.9%. Participants from Denmark(n=9), Finland(n=8), Iceland(n=1), Norway(n=10) and Sweden(n=13) contributed to the questionaire. The majority of participants expressed familiarity with the Local (71.8%) guideline followed by EAU (61.5%), National (41.0%) and AACP (7.7%) guidelines. Local (64.1%) guidelines was adhered to the most followed by EAU (43.6%) and National (23.1%) guidelines. For open nephrectomy, with no known risk factor for thrombosis, 94.9% offered Low Molecular Weight Heparin (e.g. Fragmin (Dalteparin)) followed by Early ambulation (69.2%), Graduated compression stockings (48.7%), Intermittent Pneumatic Compression stockings (5.1%) and Unfractionated Heparin (5.1%). A duration of 28 days(30.8%) was suggested by a majority while the remainder continued prophylaxis Until discharge(20.5%), 10-14 days(5.1%), ...