96: Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease

Abstract

Hysterectomy is one of the most common gynecologic surgical procedure performed in the USA. Perioperative blood transfusion increases morbidity and increases significantly health care cost. Identifying risk factor for perioperative blood transfusion can help to minimize risks. Our objective was to identify risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease. We completed a retrospective chart review of patients who had undergone abdominal, laparoscopic, or vaginal hysterectomy between January 2015 and December 2015. Demographic data and need for blood transfusion were obtained. The following risk factors for blood transfusion were analyzed, 1. Route of Hysterectomy 2. Patient’s BMI 3. Presence of adhesions 4. History of Cesarean Section 5. Uterine weight. Descriptive statistics, chi-square and independent samples t-tests were used to analyze the data. Significance was set to p < 0.05. A total of 517 charts were reviewed. Forty-seven patients (9.09%) received perioperative blood transfusion. Regarding the route of hysterectomy, the need for blood transfusion was as follows: TAH: 34/263 (12.92%), TLH: 5/119 (4.2%), LAVH: 3/35 (8.57%), and VH: 5/100 (5.0%). Having abdominal hysterectomy was a significant risk factor for need to receive blood transfusion (p=0.017). The patients who needed blood transfusion had larger BMI 33.01 vs 29.5 (p=0.002), larger mean uterine weight 933.4gm vs 542.5 gm (p=0.002). There was no association between the presence of pelvic adhesions (p=0.91) nor having personal history of cesarean section (p=0.89) with the need to receive blood transfusion. Interestingly, 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). Blood transfusion is a frequent complication in patients undergoing hysterectomy for benign disease. Having a large uterus and obesity are risk factors for the need to receive blood transfusion. The presence of pelvic adhesion was risk factor for blood transfusion only in patients undergoing a laparoscopic approach.