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Which patients on a gynecologic oncology service will require perioperative transfusion? A single-center retrospective cohort study |
Gregory W. Kirschen1, † , Samantha M. Dayton2, †, Sophia Blakey-Cheung3, Michael L. Pearl2, *( ) |
1Department of Gynecology and Obstetrics, Johns Hopkins Medicine, MD 21287 Baltimore, United States 2Department of Obstetrics, Gynecology & Reproductive Medicine, Stony Brook University Hospital, Stony Brook, 11794 NY, United States 3Department of Obstetrics and Gynecology, Northwell Health System, Southside Hospital, 11706 NY, United States
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Abstract
The purpose of this study was to determine which patient- or surgery-related factors are predictive of need for perioperative transfusion to avoid obtaining unnecessary pre-operative type and screens (T&S). We conducted an observational retrospective cohort study of 1200 women ≥ 18 years old undergoing gynecologic surgery for benign, possibly benign, or malignant indications on a gynecologic oncology service at a university medical center from 2009-2016. A logistic regression model was used to examine patient-related and surgery-related variables predictive of outcome of transfusion. Independent variables included patient demographics, comorbidities, and surgical indication surgical route, and surgical type. Dependent variable was transfusion outcome (T&S only, conversion to type and cross (T&C), or transfusion). Eight hundred ninety-nine (74.9%) women underwent pre-operative T&S, of which 118 (9.8%) were converted to T&C, and 80 (6.7%) received a transfusion of blood or blood products. Cancer indication, major surgery, and preoperative hematocrit less than 36% were significantly associated with need for transfusion (P = 0.002, P < 0.0001, P < 0.0001, respectively). Patients with a benign indication undergoing minor procedures and with normal preoperative hematocrit are least likely to require transfusion.
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Submitted: 20 May 2020
Revised: 29 June 2020
Accepted: 16 July 2020
Published: 15 February 2021
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Fund: 1F30MH110103/National Institutes of Health (NIH) |
*Corresponding Author(s):
Michael L. Pearl
E-mail: Michael.pearl@stonybrookmedicine.edu
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About author: †These authors contributed equally. |
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