Blood Transfusion in Elective Abdominal Gynecologic Surgery

Abstract

Objective: The aims of this research were to investigate the rate of blood use in elective gynecologic surgery, and to determine the appropriateness of blood ordering and utilization, and the factors associated with blood transfusion. Materials and Methods: This prospective study was conducted in women scheduled to undergo elective gynecologic surgery. Various surgery-related data were collected, including blood request data and actual blood use. Incidence of blood transfusion and other indices were estimated, including crossmatch-to-transfusion ratio (C/T ratio), transfusion index (TI), and transfusion probability (%T). Results: Two hundred and sixty women with a mean age of 48.5 ± 11.0 years were included. A majority of cases (42.7%) had benign uterine pathology, and 27.3% of cases had gynecologic malignancies. Blood requests were type and screen in 60.8% of cases. Almost half of all operations were performed by staff members (46.9%), and hysterectomy was the most common procedure (62.3%). The overall rate of blood use was 11.5%. The rate was 5.1% among type and screen cases, and 21.6% in crossmatching cases. Blood use was significantly more common among gynecologic malignancy operations than other procedures. Overall, the C/T ratio was 4.27, the TI was 0.23, and the %T was 23%, indicating over-ordering of blood. Inappropriate blood ordering was observed for patients with uterine pathology and gynecologic malignancies, for patients operated on by a fellow or staff member, and for patients undergoing hysterectomy with/without adnexal surgery or oncologic procedures. Conclusions: The rate of blood use was 11.5% in elective abdominal gynecologic surgery. Various indices showed that blood ordering and utilization is still inefficient and needs some improvements. (J GYNECOL SURG 33:231)