Perioperative outcomes for benign hysterectomy among women with thrombocytopenia

Objective To determine whether mild or moderate thrombocytopenia is associated with postoperative complications after benign hysterectomy. Methods A retrospective study of data from women who underwent benign hysterectomy included in the American College of Surgeons National Surgical Quality Improve...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2021-08, Vol.154 (2), p.233-240
Main Authors: Sheyn, David, Darvish, Ryan, Nayak, Lalitha, Myer, Sara, Claridge, Caitlin, Bretschneider, C. Emi
Format: Article
Language:English
Subjects:
hysterectomy
postoperative complications
thrombocytopenia
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Summary:Objective To determine whether mild or moderate thrombocytopenia is associated with postoperative complications after benign hysterectomy. Methods A retrospective study of data from women who underwent benign hysterectomy included in the American College of Surgeons National Surgical Quality Improvement Project Database. The data were stratified by normal platelet count, mild thrombocytopenia (100–149 × 103 platelets/µl), and moderate thrombocytopenia (50–99 × 103 platelets/µl). Multivariable logistic regression was used to determine the relationship between mild or moderate thrombocytopenia and the main outcome measures. Results Moderate thrombocytopenia was associated with an increased risk of perioperative transfusion (adjusted odds ratio [aOR], 2.87; 95% confidence interval [CI], 1.96–4.21) and reoperation (aOR, 4.03; 95% CI, 1.94–17.33), but mild thrombocytopenia was not. There was an increased risk of infection among women with both mild (aOR, 1.38; 95% CI, 1.12–1.69) and moderate (aOR, 2.00; 95% CI,1.23–3.22) thrombocytopenia. There was no association between either mild or moderate thrombocytopenia and readmission, prolonged hospital stay, or longer surgical time. Conclusion Thrombocytopenia was found to be associated with increased infectious morbidity after hysterectomy, and moderate thrombocytopenia was associated with an increased risk of perioperative transfusion and reoperation. Synopsis Among women undergoing hysterectomy for benign indications, platelet counts of 50 000 to 100 000 per microliter were associated with a higher probability of surgical complications.
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.13582