Hemodynamics, fluids & transfusion
Analysis of the incidence and risk factors of blood transfusion in robot-assisted laparoscopic total hysterectomy: a retrospective nationwide inpatient sample database study
Authors' conclusion
In conclusion, this study reports a 3.47% incidence of transfusion in RA-TLH and identifies high-risk patient profiles based on race, insurance status, and specific comorbidities. Furthermore, transfusion was independently associated with significantly poorer outcomes, including longer LOS, increased inpatient charges, and higher hospital mortality.
Study context
- Population
- Patients undergoing robot-assisted laparoscopic total hysterectomy (RA-TLH), Nationwide Inpatient Sample, 2010–2019
- Exposure
- Blood transfusion vs no blood transfusion
- Outcome
- Incidence of and risk factors for blood transfusion
Methodological detailsnationwide database (Nationwide Inpatient Sample (NIS)), multivariate logistic regression
- Nationwide database (NIS)
- Multivariate logistic regression
Main finding
As reported in the abstract
Incidence of blood transfusion · 2010 to 2019
RA-TLH patients receiving blood transfusions
3.47%
Observational data: associations, not effects.
Further findings
Comorbidities associated with transfusion risk
| OR (95% CI) | ||
|---|---|---|
| Congestive HF | 1.60 (1.21–2.13) | |
| Coagulopathy | 5.27 (4.08–6.82) | |
| Fluid and electrolyte disorders | 2.30 (1.91–2.76) | |
| Metastatic cancer | 1.83 (1.40–2.40) | |
| Pulmonary circulation disorders | 1.75 (1.16–2.63) | |
| Renal failure | 1.85 (1.43–2.38) | |
| Weight loss | 2.39 (1.68–3.43) | |
| 0.10.31310Odds ratio (log scale) |
- Anemia also associated with increased transfusion risk
- Age not identified as a risk factor for transfusion
Patient and hospital characteristics
- Self-pay patients had a higher transfusion rate
- P < 0.05
- Transfusion: longer LOS, higher total hospital costs, higher in-hospital mortality; more often at teaching hospitals and southern medical centres; higher proportion Black
Safety
Postoperative complications
- Transfusion associated with higher rates of sepsis, acute MI, cardiac arrest and shock
- P < 0.05
- Also DVT, GI hemorrhage, pneumonia, stroke, hemorrhage/seroma/hematoma, genitourinary disease, PE and conversion to open procedure
Original publication
Analysis of the incidence and risk factors of blood transfusion in robot-assisted laparoscopic total hysterectomy: a retrospective nationwide inpatient sample database study. Perioper Med (Lond). Published 6 December 2025. doi:10.
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