HaEmaturia After Transurethral resection of bladder Tumour (HEATT): A multicentre, regional collaborative analysis of factors associated with emergency re-admission with haematuria following TURBT

Sarmah, Piyush B; Al-Dhahir, Wesam; Chellapuri, Akhil; Damola, Adebiyi; Eli, Nnaemeka; Foulger, Rebecca; Harrington-Vogt, Maria; Hulligan, Stephen; Kanthabalan, Abi; Kitchen, Mark O; Malik, Salim; Moore, Madeline; Nyanhongo, Donald; Sohawon, Ridwaan; Thursby, Helen; Yallappa, Sachin; Mak, David; Chakravarti, Aniruddha

Abstract

Objective: To calculate the re-admission rate with haematuria within 30 days of elective transurethral resection of bladder tumour (TURBT), and identify factors associated with this. Materials and Methods: This was a multicentre, retrospective audit, identifying all adult patients over the age of 16 who underwent elective TURBT between 1 September and 30 November 2019. Data were collected from medical records and operation notes on patient demographics, intra-operative factors and post-operative management. Primary outcome measure was the proportion of patients emergently re-admitted with haematuria. Secondary outcome measures were the re-operation rate for haematuria, and the rate of new acute thrombotic event (TE). Fisher’s exact test was used to calculate p values within subgroups for re-admission rates. Results: 443 patients from 12 hospitals were included. Median age was 75 years (17–99). 15 patients (3.4%) were re-admitted with haematuria. Subgroup analysis demonstrated higher rate of re-admission for pre-existing antithrombotic agents (ATAs) (2.0% vs. 6.1%, p = 0.046), increased for non-Aspirin ATAs (10.5%, p = 0.0015). 52% of non-Aspirin ATAs were restarted within 48 hours of surgery; post-operative plan for restarting was not documented in 22.1%. One patient (0.23%) developed acute TE (pulmonary embolus). Conclusion: Pre-existing use of non-Aspirin ATAs is associated with increased risk of post-TURBT haematuria, with variable practice in post-operative recommencement. Level of evidence: Level 3

Citation

Sarmah, P. B., Al-Dhahir, W., Chellapuri, A., Damola, A., Eli, N., Foulger, R., Harrington-Vogt, M., Hulligan, S., Kanthabalan, A., Kitchen, M. O., Malik, S., Moore, M., Nyanhongo, D., Sohawon, R., Thursby, H., Yallappa, S., Mak, D., & Chakravarti, A. (in press). HaEmaturia After Transurethral resection of bladder Tumour (HEATT): A multicentre, regional collaborative analysis of factors associated with emergency re-admission with haematuria following TURBT. Journal of Clinical Urology, https://doi.org/10.1177/20514158231190035

• Journal Article Type: Article
• Acceptance Date: Jul 4, 2023
• Online Publication Date: Aug 7, 2023
• Deposit Date: Nov 7, 2023
• Journal: Journal of Clinical Urology
• Print ISSN: 2051-4158
• Electronic ISSN: 2051-4166
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/20514158231190035
• Keywords: Urology, Surgery, Bladder cancer, emergency urology, haematuria, anticoagulation, transurethral resection of bladder tumour
• Public URL: https://keele-repository.worktribe.com/output/543397