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Preoperative predictors of blood loss at the time of radical prostatectomy: results from the SEARCH database

Prostate Cancer and Prostatic Diseases volume 12, pages 264–268 (2009)Cite this article

Abstract

The literature contains conflicting data on preoperative predictors of estimated blood loss (EBL) at radical retropubic prostatectomy (RRP). We sought to examine preoperative predictors of EBL at the time of RRP among patients from the SEARCH database to lend clarity to this issue. A total of 1154 patients were identified in the SEARCH database who underwent RRP between 1988 and 2008 and had EBL data available. We examined multiple preoperative factors for their ability to predict EBL using multivariate linear regression analysis. Median EBL was 900 ml (s.d. 1032). The 25th and 75th percentile for EBL were 600 and 1500 ml, respectively. EBL increased significantly with increasing body mass index (BMI) and increasing prostate size and decreased with more recent year of RRP (all P<0.001). The mean-adjusted EBL in normal-weight men (BMI<25 kg/m2) was 807 ml compared to 1067 ml among severely obese men (BMI⩾35 kg/m2). Predicted EBL for men with the smallest prostates (<20 g) was 721 ml, compared to 1326 ml for men with prostates ⩾100 g. Finally, statistically significant differences between centers were observed, with mean-adjusted EBL ranging from 844 to 1094 ml. Both BMI and prostate size are predictors of increased EBL. Prostate size is of particular note, as a nearly twofold increased EBL was seen from the smallest (<20 g) to the largest prostates (⩾100 g). Over time, average EBL significantly decreased. Finally, significant differences in EBL were observed between centers. Patients with multiple risk factors should be forewarned they are at increased risk for higher EBL, which may translate into a greater need for blood transfusion.

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Acknowledgements

This study was supported by the Department of Veterans Affairs, National Institute of Health R01CA100938 (WJA), NIH Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (WJA), the Georgia Cancer Coalition (MKT), the Department of Defense, Prostate Cancer Research Program, (LLB, SJF) and the American Urological Association Foundation/Astellas Rising Star in Urology Award (SJF). Views and opinions of, and endorsements by the author(s) do not reflect those of the US Army or the Department of Defense.

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Authors and Affiliations

  1. Division of Urologic Surgery, Department of Surgery and Pathology, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

    J C Lloyd, L L Bañez & S J Freedland

  2. Urology Section, Veterans Affairs Medical Center Durham, Durham, NC, USA

    J C Lloyd, L L Bañez & S J Freedland

  3. Urology Section, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA

    W J Aronson

  4. Department of Urology, UCLA School of Medicine, Los Angeles, CA, USA

    W J Aronson

  5. Urology Section, Veterans Affairs Medical Center Augusta, Augusta, GA, USA

    M K Terris

  6. Section of Urology, Medical College of Georgia, Augusta, GA, USA

    M K Terris

  7. Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA

    J C Presti Jr

  8. Urology Section, Veterans Affairs Medical Center, Palo Alto, CA, USA

    J C Presti Jr

  9. Department of Urology, University of Alabama Birmingham, Birmingham, AL, USA

    C L Amling

  10. Urology Section, Veterans Affairs Medical Center, San Diego, CA, USA

    C J Kane

  11. Division of Urology, University of California, San Diego School of Medicine, San Diego, CA, USA

    C J Kane

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  1. J C Lloyd
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  2. L L Bañez
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  3. W J Aronson
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  4. M K Terris
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  5. J C Presti Jr
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  6. C L Amling
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  7. C J Kane
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  8. S J Freedland
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Correspondence to S J Freedland.

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Lloyd, J., Bañez, L., Aronson, W. et al. Preoperative predictors of blood loss at the time of radical prostatectomy: results from the SEARCH database. Prostate Cancer Prostatic Dis 12, 264–268 (2009). https://doi.org/10.1038/pcan.2009.6

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