Evaluation of gynecology and gynecologic oncology cases who received massive blood transfusion: a tertiary center experience

Abstract

Aims: To examine the frequency, indications and results of massive blood transfusion in gynecology and gynecological oncology cases. Methods: The data of 56 cases who were underwent massive blood transfusion and operated on for benign/ malignant pathology indications in the gynecology and gynecological oncology clinics between October 1, 2022 and August 1, 2023, within a period of 10 months, were retrospectively analyzed. Demographic data of the cases (age, gravida, parity, body mass index), indications for hospitalization, vital signs during hospitalization, hemoglobin (Hb), hematocrit (Htc), platelet and INR values, massive transfusion indications, transfused blood products (erythrocyte suspansion, fresh frozen plasma (FFP), pooled platelet suspension, cryoprecipitate, fibrinogen) and the length of stay in the intensive care unit and hospitalization were retrospectively screened and analyzed statistically. The statistical significance level was accepted as p<0.05. Results: 56 (1.8%) of 3146 patients were received massive blood transfusion. Massive blood transfusion was given to 30 (1.4%) of 2093 inpatients in the gynecology clinic, while this rate was found to be 2.5% (26/1053) in gynecologic oncology patients. The time between the decision to start transfusion and total transfusion times were similar between the groups (p>0.05). However, when the decision for transfusion was made, the INR value was statistically significantly higher in gynecological oncology cases (p=0.001). While the amounts of erythrocyte suspension given were similar between the two patient groups (5.1±1.4 vs. 6.3±3.5 U, p= 0.082), FFP amounts were higher in the gynecologic oncology group (3.3±2.0 vs. 6.2±3.7 U, p=0.001). When the blood groups of the cases were examined, it was seen that the most common blood groups were O (+) (n= 18, 32.1%) and A (+) (n=16, 28.6%). The duration of stay in the intensive care unit and hospitalization of gynecological oncology cases was significantly longer in gynecological cases. While 1 of 56 patients who underwent massive blood transfusion died (gynecological oncology case), 55 patients were discharged. Conclusion: Timely transfusion decision is safe and life-saving in massive hemorrhages.

Keywords

• Gynecology
• gynecologic oncology
• massive blood transfusion

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