Objective: The purpose of this study was to identify risk factors associated with transfusion in women undergoing hysterectomy for benign disease. Methods: A retrospective chart review of women undergoing hysterectomy between June 2007 and July 2009 was conducted. Demographic data, pre- and postoperative hemoglobin (g/dL) values, surgical indication, estimated blood loss (EBL), route of hysterectomy, uterine weight, and peri-operative complications were recorded from a departmental surgical database and electronic medical records. A logistic regression analysis was performed to identify independent risk factors for intra- and postoperative blood transfusion. Results: A total of 377 women were included. The overall rate of transfusion was 6.6%. On univariate analysis, the transfusion group had a significantly lower mean age (41.7 versus 44.8, p=0.03), lower pre- (9.28 versus 12.1, p < 0.00) and postoperative hemoglobin value (7.1 versus 10.2, p < 0.001), higher EBL (870 mL versus 289 mL, p <0.001), and higher mean uterine weight (830 g versus 421 g, p = 0.0005). Logistic regression identified only preoperative hemoglobin (odds ratio [OR] 3.0,95% confidence interval [CI] 1.9, 4.6, p< 0.001) and EBL (OR 1.004, 95% CI 1.002,1.005, p<0.001) as significant risk factors for transfusion. Route of hysterectomy revealed a trend toward a significantly lower rate in the robotic group (0/41) compared with open (19/185), vaginal (2/69), and laparoscopic (4/47) groups, p = 0.07. Conclusions: In women undergoing hysterectomy, preoperative anemia is the dominant risk factor for transfusion.
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