OBJECTIVE: To determine whether preoperative autologous blood donation is justified for patients undergoing elective abdominal or vaginal hysterectomy. DESIGN: Retrospective cohort study. PATIENTS AND SETTING: A total of 263 consecutive patients admitted for elective abdominal or vaginal hysterectomy to a community health maintenance organization hospital during 1993 and 1994. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.
OBJECTIVE: To determine whether preoperative autologous blood donation is justified for patients undergoing elective abdominal or vaginal hysterectomy. DESIGN: Retrospective cohort study. PATIENTS AND SETTING: A total of 263 consecutive patients admitted for elective abdominal or vaginal hysterectomy to a community health maintenance organization hospital during 1993 and 1994. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.
Authors: Ruchika Goel; Molly R Petersen; Eshan U Patel; Zoe Packman; Evan M Bloch; Eric A Gehrie; Parvez M Lokhandwala; Paul M Ness; Beth Shaz; Louis M Katz; Steven M Frank; Aaron A R Tobian Journal: Transfusion Date: 2020-08-31 Impact factor: 3.157