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Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease in a teaching
Michael Saad-Naguib1, Ashley Ulker2, Douglas Timmons2
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, 1321 NW 14th Street, Suite 201, Miami, FL, USA. miken412@gmail.com.
Insights
Abdominal hysterectomy, obesity, and large uterus increase the risk of perioperative blood transfusion. Identifying these factors aids patient counseling and surgical preparation for hysterectomy.
Area of Science:
- Gynecology
- Surgical Oncology
- Transfusion Medicine
Background:
- Perioperative blood transfusion is a common complication in gynecological surgery.
- Identifying risk factors for transfusion can improve patient outcomes and resource allocation.
Purpose of the Study:
- To identify risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign conditions.
Main Methods:
- Retrospective chart review of 517 patients undergoing hysterectomy for benign disease (2018-2019).
- Analysis of risk factors including hysterectomy route, BMI, adhesions, cesarean history, and uterine weight.
- Comparison between patients who received transfusion and those who did not.
Main Results:
- 9.09% of patients received perioperative blood transfusion.
- Abdominal hysterectomy route (TAH), BMI > 33.0, and increased uterine weight were significant risk factors.
- No association found between adhesions or cesarean history and transfusion, except in the case of total laparoscopic hysterectomy (TLH) where adhesions were a risk factor.
Conclusions:
- Abdominal hysterectomy, obesity, and large uterus are key risk factors for perioperative blood transfusion.
- Early identification of at-risk patients improves surgical preparation and patient counseling.
Purpose:
The purpose is to identify risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease.
Methods:
This study is a retrospective chart review including all the patients who underwent hysterectomy for benign disease between January 1st 2018 and December 31st 2019. Patients who received perioperative blood transfusion were identified and compared to those who did not. The following risk factors for blood transfusion were analyzed: route of hysterectomy, BMI, presence of adhesions, history of cesarean section, uterine weight. Descriptive statistics was used to analyze the data.
Results:
A total of 517 patients were identified and included in the study. Forty-seven patients (9.09%) received a perioperative blood transfusion. The abdominal hysterectomy route (TAH) was a significant risk factor for receiving blood transfusion (p = 0.012). Other identified risk factors for blood transfusion included: Body mass index above 33.0 (p = 0.002), and uterine weight (p = 0.002). There was no association between the presence of pelvic adhesions (p = 0.91) or a personal history of cesarean section (p = 0.89) and receiving perioperative blood transfusion. When analyzing only the patients who underwent TLH, the presence of pelvic adhesion was found as a risk factor for perioperative blood transfusion (p = 0.024).
Conclusion:
The abdominal hysterectomy route, the presence of a large uterus, and obesity are risk factors for receiving a blood transfusion. Early identification of the patient at risk of requiring perioperative blood transfusion provides better patient counseling and surgical preparation.
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