In general the need for blood transfusion following gynecologic pelvic reconstructive surgery is low. A woman undergoing pelvic reconstructive surgery may be at increased risk for blood transfusion if certain risk factors are present. The authors are from the Ohio State University.
Patient selection: gynecologic reconstructive surgery, ASA 1 to 4
Risk factors:
(1) preoperative hematocrit < 30% (adjusted odds ratio 13.7)
(2) bleeding disorder (adjusted odds ratio 3.7)
(3) ASA class (ASA 3 aOR 2.8, ASA 4 OR 6.6)
(4) open procedure (not vaginal, not minimally invasive), adjusted odds ratio 5.4
(5) race (Hispanic aOR 1.9, African American aOR 1.7)
(6) concomitant hysterectomy (adjusted odds ratio 1.8)
(7) underweight (adjusted odds ratio 1.6)
Reduced risk:
(1) overweight or obese (aOR 0.7 or 0.6)
(2) minimally invasive surgery (aOR 0.6)
Almost 80% of the patients who were not transfused had surgery for incontinence and/or prolapse, versus 60% of those transfused.
