MP05-10 DISPARATE ESTIMATES OF BENEFIT FROM POST-DISCHARGE ANTICOAGULATION AFTER CYSTECTOMY IN THE LITERATURE: IMPLICATIONS FOR COST EFFECTIVENESS?

INTRODUCTION AND OBJECTIVES:Guidelines from the EAU and other organizations recommend prolonged anticoagulation after radical cystectomy for the prevention of venous thromboembolic events (VTE). Low molecular weight heparin is generally the anticoagulant of choice, but it is both expensive and a burden for patients to administer. The benefit of extended duration anticoagulation in guideline statements is estimated using assumptions of risk reduction based on RCTs in other areas (e.g. orthopedics), but do not include randomized studies of cystectomies with no prolonged anticoagulation. In order to provide an estimate of real world risk with and without prolonged prophylaxis, we performed a systematic review of cystectomy studies to assess reported risks of VTE in the published literature.METHODS:PubMed and Medline were queried for all studies pertaining to "radical cystectomy" to capture all series of cystectomies. Studies in English reporting on patients operated on after 1990 with data on post-discharge ...