A study of blood utilization in association with hysterectomy

Authors

  • S.K. Samra MD,

    Assistant Professor, Corresponding author
    1. Departments of Anesthesiology, Pathology, and Biostatistics, University of Michigan Schools of Medicine and Epidemiology, Ann Arbor, Michigan.
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  • B.A. Friedman,

    1. Departments of Anesthesiology, Pathology, and Biostatistics, University of Michigan Schools of Medicine and Epidemiology, Ann Arbor, Michigan.
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    • 2

      Bruce A. Friedman, MD, Professor of Pathology, University of Michigan Medical School, c/o Department of Pathology, 1315 Catherine Road, Box 45, Ann Arbor, MI 48109.

  • P.J. Beitler

    1. Departments of Anesthesiology, Pathology, and Biostatistics, University of Michigan Schools of Medicine and Epidemiology, Ann Arbor, Michigan.
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    • 3

      Paula J. Beitler, PhD, Biometrician, Ortho Pharmaceutical Corporation, Route 202 South, Raritan, NJ 08869.


4University of Michigan Medical School, c/o Department of Anesthesiology, S6344 University Hospital, Ann Arbor, MI 48109.

Abstract

We performed a retrospective study of 167 women undergoing hysterectomy in a large tertiary-care teaching hospital in order to assess intraoperative blood requirements and to study the decision-making process that occurs when blood is transfused intraoperatively. Recommended preoperative blood orders for hysterectomy patients based on data from the study are provided. Although “type and screen” is commonly considered to be an adequate preoperative order for patients undergoing vaginal hysterectomy, our data indicate that 2 units may be a more appropriate order when the procedure is combined with pelvic floor repair. The preoperative hematocrit, the estimated intraoperative blood loss, and the duration of the hysterectomy were integral to the decision-making process. If women undergoing hysterectomy were transfused intraoperatively only when their hematocrit actually fell to 30 percent, and not in anticipation of such an event, unnecessary transfusions would be reduced.

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