Risk factors for blood transfusion in patients undergoing hysterectomy for stage I endometrial cancer

To highlight the risk factors contributing to blood transfusion among patients undergoing surgical intervention for Stage I Endometrial Cancer (EC).

Using the American College of Surgeons National Surgical Quality Improvement Program database, a nationally validated database dedicated to improving surgical care, females over the age of 18 who underwent surgery for EC stage I between the years 2016-2022 were queried. The cohort was then characterized based on those who received blood transfusion 72 h postoperatively.

27,183 patients with endometrial cancer who received surgical management were identified. 668 (2.5%) of those patients received blood transfusions. A multivariate logistic model found that a medical factor low preoperative Hct % (aOR 22.4, 95% CI[17.7, 28.3]; p < 0.001) and surgical factors such as 180 min or more of operative time (aOR 3.38, 95% CI[2.77, 4.14]; p < 0.001), larger uteri of 250-500 g (aOR 1.93, 95% CI[1.48, 2.49]; p < 0.001) and ≥ 500 g (aOR 2.35, 95% CI[1.77, 3.12]; p < 0.001), and abdominal approach compared to laparoscopic (aOR 6.36,95% CI[4.95, 8.18]; p < 0.001) were significantly associated with receiving blood transfusion.

Many significant risk factors were found to be associated with blood transfusions in patients with Stage I endometrial cancer. These findings allow surgeons to proactively prepare adequate measures for patients who may require blood transfusions when they undergo surgery for endometrial cancer.