Current Status and Characteristics of Perioperative Transfusion in Gynecologic Patients

  Objective  To analyze the current status and characteristics of perioperative transfusion in patients undergoing gynecologic surgery and to explore the rational management of blood product use.

  Methods  Clinical data of patients who underwent gynecologic surgery in Peking Union Medical College Hospital from January to October in 2014 were retrospectively reviewed. Those who received perioperative transfusion were analyzed to summarize the status and characteristics of transfusion for different diseases and surgical procedures. The data of patients in 2014 were compared with those of patients in the corresponding period of 2013.

  Results  Altogether 6203 patients underwent gynecologic surgery in Peking Union Medical College Hospital from January to October in 2014, including 286 patients who had allogeneic transfusion during perioperative period, and 80 who had autologous transfusion. The total number of surgery in 2014 increased by 10.5% compared with the same period in 2013, while the allogeneic transfusion rate in 2014 (4.6%) decreased by 27% compared with the same period in 2013 (P=0.001). Operations for malignancies had higher transfusion rates than those for mild diseases. Cytoreductive surgery and re-cytoreductive surgery for ovarian cancer had the highest rate of transfusion (45.3%), and the average transfusion volume was 6.7 U. Laparoscopy had lower transfusion rate compared with laparotomy. In radical resection of cervical cancer, approach by laparoscopy had a lower rate of transfusion than by laparotomy (6.2% vs. 10.9%). Autologous transfusion was applied mainly in operations for ectopic pregnancy or internal bleeding due to rupture of corpus luteum, myomectomy and total hysterectomy, with autologous transfusion rates being 17.0%, 5.2%, and 2.8%, and average transfusion volume being 749, 429, and 397 ml, respectively.

  Conclusions  Perioperative transfusion rate in 2014 was lower than in 2013 despite more gynecologic operations in 2014. Rational blood use in gynecologic patients can be managed by strategies including selection of appropriate surgery procedures, application of minimally invasive surgery, and proper use of autologous trasfusion.