8010 Postoperative Abscess Risk with Hemostatic Agent Use in Hysterectomy

Abstract

<h3>Study Objective</h3> We noticed a trend of increased re-admissions for post-op pelvic abscesses. In an attempt to further investigate causality, we identified use of hemostatic agents as a possible culprit. The study objectives were to determine if intra-operative use of hemostatic agents was associated with postoperative abscess formation in patients undergoing hysterectomy. <h3>Design</h3> Retrospective chart review identified women who underwent hysterectomy by a Gynecologic Oncologist for any indication at a single institution from January 1, 2019, through December 31, 2019. Patient and surgical characteristics were abstracted, and comparisons were made among those who received any hemostatic agent and those that did not. <h3>Setting</h3> Study was performed at an academic institution in rural Virginia. <h3>Patients or Participants</h3> 428 hysterectomies were identified among five providers over a one-year period, with a postoperative pelvic abscess rate of 3.7%. <h3>Interventions</h3> The relationship between intra-operative hemostatic agentuse and post-op pelvic abscess formation was determined using multivariate logistic regression. Secondary outcomes evaluated included the presence of other major post-operative adverse events, such as post-operative blood transfusion, presentation to the emergency room, readmission or re-operation. <h3>Measurements and Main Results</h3> Abscesses were identified in 4 (2.2%)of cases without <i>vs</i> 12 (4.9%) of cases with hemostatic use with a logistic regression model demonstrating no significant difference in the groups (OR=2.10, <i>p</i>=0.22). Data showed an increase in presentation to the ED (OR=3.43, <i>p</i>=0.002 adjusted) and higher odds of readmission to the hospital within 30 days of surgery (OR=3.19, <i>p</i>=0.03) with hemostatic agent use. <h3>Conclusion</h3> There was no association found between the use of hemostatic agent use and abscess formation; however, data showed hemostatic agent use in surgery was associated with increased odds of presentation to the ED and readmission to the hospital within 30 days of surgery.