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Clinical utility of postoperative hemoglobin level testing following total laparoscopic hysterectomy.
Chamsy, Dina J; Louie, Michelle Y; Lum, Deirdre A; Phelps, Amy L; Mansuria, Suketu M.
Afiliação
  • Chamsy DJ; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Louie MY; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Lum DA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Phelps AL; Department of Economics and Statistics, Duquesne University, Pittsburgh, PA.
  • Mansuria SM; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: manssm@upmc.edu.
Am J Obstet Gynecol ; 211(3): 224.e1-7, 2014 Sep.
Article em En | MEDLINE | ID: mdl-24721262
OBJECTIVE: To determine the clinical utility of hemoglobin level testing in guiding postoperative care following total laparoscopic hysterectomies performed for benign indications. STUDY DESIGN: Retrospective cohort study. RESULTS: A total of 629 women underwent total laparoscopic hysterectomies during the 24 month study period. Only 16 (2.5%) developed symptoms and/or signs suggestive of hemodynamic compromise. When compared to asymptomatic patients, symptomatic patients had a larger decrease in postoperative hemoglobin level (2.66 vs 1.80g/dL, P = .007) and were more likely to undergo blood transfusion, pelvic imaging or reoperation (P < .001). Women with a smaller body mass index and/or higher intraoperative intravenous fluid volume were more likely to have a larger decrease in postoperative hemoglobin level (P < .05). Past surgical history, duration and complexity of the hysterectomy, estimated surgical blood loss, uterine weight, and perioperative use of intravenous ketorolac were not associated with a greater decrease in postoperative hemoglobin (P > .05). Using the University of Pittsburgh Medical Center's annual laparoscopic hysterectomy rate and insurance companies' reimbursement for blood hemoglobin testing, we estimated the national annual cost for hemoglobin testing following total laparoscopic hysterectomy to be $2,804,662. CONCLUSION: Hemoglobin level testing has little clinical benefit following elective total laparoscopic hysterectomy and should be reserved for patients who develop signs or symptoms suggestive of acute anemia. Heath care cost savings can be substantial if this test is no longer routinely requested following total laparoscopic hysterectomies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Hemoglobinas / Laparoscopia / Histerectomia Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Am J Obstet Gynecol Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Hemoglobinas / Laparoscopia / Histerectomia Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Am J Obstet Gynecol Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos