Factors associated with the need for blood transfusion during hysterectomy.
OBJECTIVE
To identify the preoperative clinical conditions associated with the need to perform a blood transfusion among patients undergoing hysterectomy.


METHODS
In a retrospective, comparative, case-control trial at the University Hospital, Nuevo León, Mexico, the records of patients who underwent elective hysterectomy between 2007 and 2009 were reviewed. Patients were grouped depending on whether or not they required blood transfusion. Clinical features were compared and statistical analysis was performed via the χ(2) test.


RESULTS
Among 794 patients who underwent hysterectomy, 89 (11.2%) required transfusion. The factors significantly associated with transfusion were history of abnormal uterine bleeding (67.0% versus 52.1%), preoperative hemoglobin level (10.1g/dL versus 12.3g/dL), magnitude of intra-operative bleeding (410 mL versus 298 mL), and operative time (172 min versus 144 min); P<0.001. A significant number of patients who underwent transfusion had increased preoperative prothrombin levels; P=0.04.


CONCLUSIONS
Hemoglobin level before surgery and a history of abnormal uterine bleeding can be identified preoperatively and might warn about the possibility of a need for transfusion among patients undergoing hysterectomy. For young patients, alterations in clotting mechanisms should be ruled out.
University Center for Reproductive Medicine, Autonomous University of Nuevo León, Monterey, Mexico. lsordia@prodigy.net.mx
Luis H
LH
Sordia-Hernández
Donato S
DS
Rodriguez
Oscar
O
Vidal-Gutierrez
Arturo
A
Morales-Martinez
María O
MO
Sordia-Piñeyro
Geraldina
G
Guerrero-Gonzalez
D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D061646:Operative Time; D011516:Prothrombin / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014592:Uterine Hemorrhage / Q000150:complications
D006454:Hemoglobins; D011516:Prothrombin