IMR Press / CEOG / Volume 48 / Issue 1 / DOI: 10.31083/j.ceog.2021.01.2152
Open Access Original Research
Which patients on a gynecologic oncology service will require perioperative transfusion? A single-center retrospective cohort study
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1 Department of Gynecology and Obstetrics, Johns Hopkins Medicine, MD 21287 Baltimore, United States
2 Department of Obstetrics, Gynecology & Reproductive Medicine, Stony Brook University Hospital, Stony Brook, 11794 NY, United States
3 Department of Obstetrics and Gynecology, Northwell Health System, Southside Hospital, 11706 NY, United States

These authors contributed equally.

Clin. Exp. Obstet. Gynecol. 2021, 48(1), 47–52; https://doi.org/10.31083/j.ceog.2021.01.2152
Submitted: 20 May 2020 | Revised: 29 June 2020 | Accepted: 16 July 2020 | Published: 15 February 2021
Abstract

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.

Keywords
Blood loss
Hemorrhage
Minimally-invasive surgery
Cost savings
Evidence-based practice
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