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Improving Anemia and CurbinAg Transfusion in Gynecologic Surgery (IMPACT-GS): Multidisciplinary and multimodal
Innie Chen1, Karima Khamisa2, Aisling Clancy3
1Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON; Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON; The Ottawa Hospital Research Institute, Ottawa, ON; Department of Anesthesiology and Pain Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, ON.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|July 10, 2026
Summary
A new intervention bundle improved pre-operative hemoglobin levels and significantly reduced blood transfusion rates in gynecologic surgery patients. This multidisciplinary approach enhances surgical outcomes by optimizing hematologic parameters.
Area of Science:
- Gynecologic Surgery
- Anemia Management
- Transfusion Medicine
Background:
- Pre-operative anemia is a significant risk factor in gynecologic surgery.
- Optimizing hemoglobin levels pre-operatively can reduce the need for blood transfusions.
- Multidisciplinary and multimodal interventions are emerging strategies for patient blood management.
Purpose of the Study:
- To evaluate the impact of a comprehensive intervention bundle on pre-operative hematologic parameters.
- To assess the effect of this intervention on peri-operative and post-operative transfusion rates in patients undergoing hysterectomy.
Main Methods:
- Development and implementation of a hemoglobin optimization bundle including clinical algorithms, nursing interventions, EMR reminders, patient education, and team communication.
- Retrospective analysis of 2026 hysterectomies (908 pre-intervention, 1118 post-intervention).
Main Results:
- Mean pre-operative hemoglobin increased significantly (129.7 to 131.7 g/L).
- Reduced rates of severe pre-operative anemia (Hb <110 g/L and Hb <100 g/L).
- Significant decrease in peri-operative (4.3% to 2.5%) and post-operative (3.5% to 2.0%) transfusion rates.
Conclusions:
- A multidisciplinary, multimodal pre-operative hemoglobin optimization strategy is effective.
- This approach significantly reduces transfusion requirements in gynecologic surgery.
- Optimizing hematologic parameters improves surgical outcomes and patient safety.
