Impact of Pharmacologic Thromboprophylaxis on Venous Thromboembolism and Bleeding Complications Following Pelvic Organ Prolapse Procedures.
Document Type
Article
Publication Date
2025
Publication Title
International Urogynecology Journal
Abstract
INTRODUCTION AND HYPOTHESIS: Current literature provides conflicting evidence regarding venous thromboembolism (VTE) pharmacologic thromboprophylaxis benefits in the context of postoperative bleeding complications in the setting of pelvic organ prolapse (POP) surgery. We hypothesized that patients receiving VTE pharmacologic thromboprophylaxis, compared to those who did not, would have a similar rate of VTE but higher bleeding complication rates.
METHODS: This was a retrospective cohort study utilizing the Premier Healthcare Database. Patients who underwent POP surgery between January 2000 and March 2020 were identified and grouped by those who received a single dose of pharmacologic thromboprophylaxis and those who did not. Data were analyzed using Kruskal-Wallis, chi-squared tests, and inverse probability of treatment weighted analysis, as appropriate. The primary outcome was rate of composite bleeding complications within 3 months, and secondary outcomes were rate of VTE, emergency department visits, and readmissions.
RESULTS: The cohort included 214,427 patients, of which 13.7% received pharmacologic thromboprophylaxis. In the unweighted analysis, those who received pharmacologic thromboprophylaxis had higher rates of composite bleeding complications (1.1% vs 0.7%, p < 0.001). The rate of VTE was higher in those with pharmacologic thromboprophylaxis (0.23% vs 0.16%, p = 0.007). These findings persisted after using inverse probability of treatment weighted analysis to adjust for confounding factors, with an increased probability of developing bleeding complications (OR 1.51 [1.32, 1.71]) and VTE (OR 1.42 [1.08, 1.87]).
CONCLUSIONS: When weighted on preoperative and operative characteristics, patients who received a single dose of thromboprophylaxis had increased risks of bleeding complications and VTE.
Recommended Citation
Bauer HH, Schlussel MA, Rhodes SP, Hijaz AK, Sheyn D. Impact of pharmacologic thromboprophylaxis on venous thromboembolism and bleeding complications following pelvic organ prolapse procedures. Int Urogynecol J. 2025. doi: 10.1007/s00192-025-06375-9. PMID: 41081819.
DOI
10.1007/s00192-025-06375-9
ISSN
1433-3023
PubMed ID
41081819