Incidence and risk factors for blood transfusion after abdominal radical hysterectomy for cervical cancer: A 10-year retrospective study of the US nationwide inpatient sample

Abstract

Purpose With the increasing prevalence of abdominal radical hysterectomy, the need for perioperative blood transfusion has emerged as a significant clinical challenge. The independent risk factors for blood transfusion during abdominal radical hysterectomy remain limited, and identifying these factors is needed. Methods The Kolmogorov‒Smirnov test was used to assess the normality of continuous variables. Continuous variables with normal distributions were evaluated using Student’s t test, and noncontinuous variables were evaluated using the Mann‒Whitney U test. Categorical variables were evaluated using the χ2 test. Multivariate logistic regression analyses were implemented to identify potential predictors. Results Blood transfusions occurred in 14.84% of patients between 2010 and 2019, with a decreasing trend over time. Receiving a transfusion was associated with several negative outcomes, including a longer length of stay, higher total charges, and an increased risk of complications such as thrombocytopenia, acute myocardial infarction, and pneumonia. Additionally, patients who received transfusions were more likely to experience postoperative delirium, deep vein thrombosis, and wound infection. Independent risk factors for blood transfusion included age greater than 60 years, black race, Asian or Pacific Islander race, nonelective surgery, hospitalization in a rural setting, and preexisting medical conditions such as coagulopathy, chronic blood loss anemia, and deficiency anemia. Conversely, patients with private insurance residing in the West or Midwest/North Central Regions were less likely to require a blood transfusion. Conclusion Stratifying analyses by race, geographic region, and comorbidity profile among cervical cancer patients is important for enabling the implementation of targeted interventions and improving patient care.