Perioperative Blood Transfusions: Risk Factors for Patients Undergoing Hysterectomy for Benign Disease [29B

Abstract

INTRODUCTION: Perioperative blood transfusion increases morbidity and increases significantly health care cost. Identifying risk factors 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 indications. METHODS: We completed a retrospective chart review of patients who had undergone abdominal, laparoscopic, or vaginal hysterectomy. 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 statistic was used to analyze the data. RESULTS: 517 charts were reviewed. Forty-seven patients (9.09%) received perioperative blood transfusion. The route of hysterectomy was as follows: TAH: 34/263 (12.92%), TLH: 5/119 (4.2%), LAVH: 3/35 (8.57%), and VH: 5/100 (5.0%). Abdominal hysterectomy was a significant risk factor for receiving blood transfusions (P=.017). The patients who needed blood transfusion had larger BMI 33.01 vs 29.5 (P=.002), larger uterine weight 933.4 gm vs 542.5 gm (P=.002). There was no association between the presence of adhesions (P=.91) nor history of cesarean section (P=.89) with the need to receive blood transfusion. When analyzing only the patients who underwent TLH, pelvic adhesions was found as a risk factor for perioperative blood transfusion (P=.024). CONCLUSION: 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.