Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease in a teaching institution

Abstract

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 1 st 2018 and December 31 st 2019. Patients who received perioperative blood transfusion were identi ed 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 identi ed and included in the study. Forty-seven patients (9.09 %) received a perioperative blood transfusion. The abdominal hysterectomy route (TAH) was a signi cant risk factor for receiving blood transfusion (p=0.012). Other identi ed 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 identi cation of the patient at risk of requiring perioperative blood transfusion provides better patient counseling and surgical preparation.

Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy

“…The study aimed to identify risk factors associated with perioperative blood transfusion. The findings revealed an overall blood transfusion rate of 9.09% [ 5 ], indicating a higher likelihood of needing a blood transfusion in a teaching institution. That may be because the situation of patients in teaching hospitals is more serious.…”

“…In our study, the variable of teaching hospitals was also included for observation. The number of the retrospective studies is relatively small, and the observation time is relatively short [ 5 ]. It is possible that our study was more convincing to detect a the overall transfusion rate of TLH.…”

“…It is worth mentioning that blood transfusions are commonly performed during surgeries. Although safety measures are in place nowadays, blood transfusions still carry risks, including acute reactions, medical mistakes, and the potential for viral or bacterial infections [ 5 , 6 ]. Therefore, it is crucial to develop a strategy before surgery to prevent the need for perioperative blood transfusions in patients undergoing the TLH.…”

“…In a retrospective study, 517 patients were identified and included, revealing that 47 (9.09%) individuals received a blood transfusion during the perioperative period. It was discovered that pelvic adhesion increased the risk of receiving a blood transfusion for those undergoing TLH [ 5 ]. Another study discovered that patients who had a larger uterus, a greater estimated blood loss during the procedure, and had a longer operative time were found to be more prone to receiving a blood transfusion [ 7 ].…”

The role of minimally invasive gynecologic surgeons in the era of subspecialties: when to refer and consult

“…It is generally accepted that obesity regardless of specific class is associated with perioperative complications and increased operative time that increases exposure time to anesthesia as well [43]. Likewise, although more evidence is necessary to define a certain uterine weight as independently associated with perioperative complications, uterine weight greater than 250 g has generally been accepted as a cutoff for surgical difficulty, complications, need for blood transfusion, and aggregate risk [44][45]. Prior surgeries and their sequelae have also been implicated in the complexity of performing laparoscopic hysterectomies.…”