The purpose of this study was to determine which patient- or surgery-related
factors are predictive of need for perioperative transfusion to avoid obtaining
unnecessary pre-operative type and screens (T&S). We conducted an observational
retrospective cohort study of 1200 women 18 years old undergoing
gynecologic surgery for benign, possibly benign, or malignant indications on a
gynecologic oncology service at a university medical center from 2009-2016. A
logistic regression model was used to examine patient-related and surgery-related
variables predictive of outcome of transfusion. Independent variables included
patient demographics, comorbidities, and surgical indication surgical route, and
surgical type. Dependent variable was transfusion outcome (T&S only, conversion
to type and cross (T&C), or transfusion). Eight hundred ninety-nine (74.9%)
women underwent pre-operative T&S, of which 118 (9.8%) were converted to T&C,
and 80 (6.7%) received a transfusion of blood or blood products. Cancer
indication, major surgery, and preoperative hematocrit less than 36% were
significantly associated with need for transfusion (P = 0.002, P 0.0001, P 0.0001, respectively). Patients with a benign indication undergoing minor
procedures and with normal preoperative hematocrit are least likely to require
transfusion.