NEAUA Main Site   | Past & Future Meetings
The New England Section of the American Urological Association
Meeting
Home
Accreditation
Information
Preliminary
Program
Registration
Information
Housing
Information
Exhibitors &
Sponsors
Local Area
Attractions

Back to 2016 Annual Meeting


The safety of preoperative aspirin for patients undergoing renal surgery: a population-based analysis
Philip J. Cheng, MD, Adam B. Althaus, MD, Steven L. Chang, MD.
Brigham and Women's Hospital, Boston, MA, USA.

Background
Urologic guidelines recommend discontinuing aspirin prior to major urologic surgery due to the perceived risk of hemorrhage. However, in certain high-risk patients holding aspirin for surgery may place undue risk of perioperative cardiovascular or cerebrovascular complications. We utilized a contemporary nationally representative database to assess the safety of perioperative aspirin for patients undergoing renal surgery.  
Methods
Using the Premier Hospital Database (Premier Inc, Charlotte, NC), which is a hospital discharge database including over 600 hospitals in the United States, we captured patients undergoing elective radical or partial nephrectomy for the management of kidney cancer or renal mass from 2003 to 2013, and divided the cohort by aspirin use on the day of surgery. We excluded patients from hospitals with no record of any perioperative aspirin use during the study period and those who had a possible cardiovascular or cerebrovascular event on the day of surgery. Multivariable regression analyses, controlling for patient and hospital factors as well as surgical approach, were used to assess the association between aspirin use and perioperative outcomes. Sampling weights and hospital clustering were employed to achieve a nationally representative estimate.
Results
The cohort was comprised of 304,055 patients, with 3044 (1.0%) receiving aspirin on the day of surgery; 79,661 (26.2%) underwent a partial nephrectomy. There were no significant differences between the two groups regarding intraoperative and post-operative complications (Table); there was a significantly increased odds for 30-day myocardial infarction in the aspirin group (OR 2.93, p = 0.001). The same associations were seen with subgroup analyses for radical and partial nephrectomy.
Conclusions
We did not find that aspirin use was associated with an increase in surgical morbidity for renal surgery even though the patients on aspirin in our cohort potentially had an elevated cardiovascular risk, as reflected by the higher incidence of post-operative myocardial infarction. Continuing aspirin among patients undergoing renal surgery appears to be safe.


Back to 2016 Annual Meeting


Old Port
Bay by Holiday Inn
Lighthouse
© 2022 New England Section of the American Urological Association. All Rights Reserved. Privacy Policy.
Banner photo courtesty of Holiday Inn By the Bay © InterContinental Hotels.