Preoperative autologous blood donations before elective hysterectomy.
OBJECTIVE
To determine whether preoperative autologous blood donation is justified for patients undergoing elective abdominal or vaginal hysterectomy.


METHODS
Retrospective cohort study.


METHODS
A total of 263 consecutive patients admitted for elective abdominal or vaginal hysterectomy to a community health maintenance organization hospital during 1993 and 1994.


METHODS
Evaluation of transfusion rates for patients who did and did not donate autologous blood; determination of any risk factors that would predict the need for transfusion; and evaluation of the need for transfusion based on chart review.


RESULTS
Of 263 patients, 26 received a blood transfusion. The major risk factor identified for transfusion was the donation of autologous blood. Of 140 patients who donated autologous blood, 25 were transfused, whereas just 1 patient of 123 who did not donate autologous blood was transfused (P<.001). Patients who donated autologous blood had significantly lower mean admission hemoglobin level than patients who did not donate (119 g/L vs 132 g/L; P<.05); logistic regression showed that autologous donation was an independent risk factor for transfusion.


CONCLUSIONS
For hysterectomy patients, donation of autologous blood causes anemia and is associated with a more liberal transfusion policy. These 2 factors result in a markedly increased incidence of transfusion with its associated risks. Elimination of preoperative autologous donation for these patients should not result in frequent exposure to allogeneic blood.
Kanter
M H
MH
Kaiser Permanente Medical Center, Woodland Hills, CA, USA.
van Maanen
D
D
Anders
K H
KH
Castro
F
F
Mya
W W
WW
Clark
K
K
D000328:Adult; D000740:Anemia / Q000209:etiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007044:Hysterectomy; D016015:Logistic Models; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D006454:Hemoglobins