Risk factors for blood transfusion in patients undergoing hysterectomy for stage I endometrial cancer

TL;DR

The study identifies risk factors for blood transfusion in patients with stage I endometrial cancer undergoing surgery.

Contribution

The study identifies specific preoperative and surgical risk factors for blood transfusion in stage I endometrial cancer patients.

Findings

Low preoperative hematocrit is strongly associated with blood transfusion.

Longer operative time and larger uterine size increase transfusion risk.

Abdominal surgery is more likely to require transfusion than laparoscopic surgery.

Abstract

To highlight the risk factors contributing to blood transfusion among patients undergoing surgical intervention for Stage I Endometrial Cancer (EC).

Using the American College of Surgeons National Surgical Quality Improvement Program database, a nationally validated database dedicated to improving surgical care, females over the age of 18 who underwent surgery for EC stage I between the years 2016–2022 were queried. The cohort was then characterized based on those who received blood transfusion 72 h postoperatively.

27,183 patients with endometrial cancer who received surgical management were identified. 668 (2.5%) of those patients received blood transfusions. A multivariate logistic model found that a medical factor low preoperative Hct % (aOR 22.4, 95% CI[17.7, 28.3]; p < 0.001) and surgical factors such as 180 min or more of operative time (aOR 3.38, 95% CI[2.77, 4.14]; p < 0.001), larger uteri of 250–500 g (aOR 1.93, 95% CI[1.48, 2.49]; p < 0.001) and ≥ 500 g (aOR 2.35, 95% CI[1.77, 3.12]; p < 0.001), and abdominal approach compared to laparoscopic (aOR 6.36,95% CI[4.95, 8.18]; p < 0.001) were significantly associated with receiving blood transfusion.

Many significant risk factors were found to be associated with blood transfusions in patients with Stage I endometrial cancer. These findings allow surgeons to proactively prepare adequate measures for patients who may require blood transfusions when they undergo surgery for endometrial cancer.

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