Preoperative crossmatch ordering and blood use in elective hysterectomy.

Preoperative crossmatch guidelines have been shown to improve crossmatch ordering practices. To refine crossmatch ordering, specific characteristics of 258 patients who underwent abdominal hysterectomy and 277 patients who underwent vaginal hysterectomy were correlated with blood transfusion by univariate and multivariate analyses. Abdominal hysterectomy patients with pelvic inflammatory disease with adhesions and/or abscess were significantly more likely to require blood transfusion. Specimen weight correlated significantly with blood transfusion only for patients with ovarian pathology. Blood use was independently correlated with reduced preoperative hemoglobin and with estimated blood loss. Vaginal hysterectomy patients who had a colporrhaphy were more likely to require blood transfusion. Preoperative crossmatch recommendations made on the basis of these results reduce costs and increase the efficiency of predeposit autologous transfusion programs and preoperative crossmatch ordering practices.