Trends in age and antithrombotic therapy in patients who underwent transurethral resection of bladder tumor and perioperative complications.

Abstract

Introduction: We investigated the subsequent trends in age and antithrombotic therapy in patients who underwent transurethral resection of bladder tumor (TURBT) and examined the rate of perioperative complications.

Methods: Medical records of patients who underwent TURBT were retrospectively analyzed. We arbitrarily divided the observation years into three periods (I: 2007-2013, II: 2014-2018, and III: 2019-2023) to compare the trends in age and frequency of perioperative complications after TURBT between patients taking and those not taking antithrombotic drugs.

Results: The number of patients who underwent TURBT was 173, 224, and 224 in periods I, II, and III, respectively. The proportion of patients receiving antithrombotic drugs was similar among the three periods (34.1%, 29.9%, and 37.5% in periods I, II, and III, respectively). The percentage of patients taking antithrombotic medications who were aged ≥80 was gradually increasing. The usage of warfarin (25.4%, 13%, and 4.2% in periods I, II, and III, respectively) and aspirin (65.1%, 40.3%, and 32.3% in periods I, II, and III, respectively) was decreased, whereas direct oral anticoagulant (1.6%, 18.2%, and 35.4% in periods I, II, and III, respectively) and clopidogrel (4.8%, 15.6%, and 16.7% in periods I, II, and III, respectively) administrations was increased. The rate of hemorrhagic and cardiocirculatory complications was higher in patients receiving antithrombotic drugs than in patients not receiving them. Of the patients receiving antithrombotic therapy, two patients with a history of cardiac infarction and deep vein thrombosis passed away after TURBT due to ischemic heart disease.

Conclusion: The age of patients receiving antithrombotic drugs has increased, and antithrombotic drug types have changed among those who underwent TURBT. Further attention to hemorrhagic and lethal cardiocirculatory complications after TURBT will be required in a super-aged society.