The Utility of Postoperative Hemoglobin Testing for Benign Hysterectomy and Myomectomy

Abstract

<h3>Study Objective</h3> To evaluate the incidence of a significant decrease in hemoglobin (Hgb), defined as ≥ 2g/dL, on routine labs postoperative day 1 (POD1) after benign hysterectomy and myomectomy and compare subsequent interventions in those with and without a significant decrease. <h3>Design</h3> This is a retrospective cohort study. Operative notes and clinical encounters up to six weeks after surgery were reviewed. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> Those undergoing laparoscopic, robotic-assisted, abdominal, or vaginal hysterectomy or myomectomy from 1/2014- 1/2019 at a tertiary referral center. Patients with known malignancy, hysteroscopic or concomitant cesarean surgeries were excluded. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> Table 1 includes patient characteristics. Descriptive statistics compared outcomes between those with and without Hgb decrease ≥ 2 g/dL on POD1. 1120 patients were included. 984 had pre- and post-operative Hgb, 41% with a significant decrease. A decrease was least common with the laparoscopic route. Postoperative interventions were not significantly different between groups. (Table 2) However, those with a significant Hgb decrease more frequently had an additional CBC drawn. When comparing those with routine postoperative labs drawn (n=1017) vs. without (n=103) there were no differences in interventions other than additional lab draws and length of stay. <h3>Conclusion</h3> There is limited utility in measuring postoperative hemoglobin routinely after benign hysterectomy and myomectomy given no difference in interventions performed between groups.