Abstract
Objective:
The aims of this retrospective cohort study were to determine the proportion of women on medical therapy to correct anemia, defined as hemoglobin <12.0g/dL prior to myomectomy and to determine the association between preoperative optimization and transfusion rates, accounting for preoperative anemia.
Materials and Methods:
Patients undergoing myomectomy (open, laparoscopic, or robot-assisted) between February 2015 and June 2018 at a single high-volume academic hospital were included.
Results:
There were 224 patients who underwent open (70.5%), laparoscopic (10.7%), or robotic (18.8%) myomectomy, with 30.4% (n = 68) anemic immediately prior to surgery. Of those patients, 76.5% (n = 52) received medical preoperative optimization before surgery: 23 (33.8%) had iron therapy alone; 16 (23.5%) had hormonal therapy alone; 12 (17.7%) had iron and hormonal therapy; and 9 (13%) had tranexamic acid. Perioperative blood transfusion—a transfusion given intraoperatively or within 2 days postoperatively was given to 32 (14.3%) patients; 84.4% (n = 27) were open cases. Half (n = 16) of the transfused patients were anemic before surgery and 25% were not receiving preoperative medical optimization. Preoperative anemia significantly increased the odds of perioperative blood transfusion (odds ratio [OR] = 2.69, 95% confidence interval [CI] :1.26–5.77; p = 0.011). Taking medications prior to surgery did not affect the odds of receiving transfusion across all patients, including those with preoperative anemia (adjusted OR = 0.87; 95% CI: 0.38–1.98; p = 0.732).
Conclusions:
One quarter of transfused patients were not on medications preoperatively despite being anemic. An attempt should be made to optimize and correct anemia actively prior to myomectomy, particularly for a planned open procedure. (J GYNECOL SURG 38:120)
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