Is Cross-Matching Required? Analysis of Blood Transfusion in Gynecological Surgeries at an Academic Hospital in Bangkok, Thailand: A Cross-Sectional Study
Issued Date
2026-04-01
Resource Type
eISSN
23988835
Scopus ID
2-s2.0-105034344810
Journal Title
Health Science Reports
Volume
9
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
Health Science Reports Vol.9 No.4 (2026)
Suggested Citation
Topipat C., Chulnoul P. Is Cross-Matching Required? Analysis of Blood Transfusion in Gynecological Surgeries at an Academic Hospital in Bangkok, Thailand: A Cross-Sectional Study. Health Science Reports Vol.9 No.4 (2026). doi:10.1002/hsr2.72086 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116086
Title
Is Cross-Matching Required? Analysis of Blood Transfusion in Gynecological Surgeries at an Academic Hospital in Bangkok, Thailand: A Cross-Sectional Study
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Abstract
Background and Aims: Effective utilization of perioperative blood transfusions can reduce costs and minimize blood waste. This study aimed to audit the appropriateness of current blood utilization practices in gynecological surgeries, characterize transfusion rates, and identify associated risk factors for transfusion. Materials and Methods: A retrospective, cross-sectional study was conducted from January 2021 to October 2023, involving 2394 patients who had perioperative blood requests and underwent gynecological surgeries in the Departmental Theatres at Ramathibodi Hospital. Patient characteristics and clinical profiles, particularly the quantities of packed red blood cells (PRC) requested and utilized, were reviewed. The appropriateness of blood utilization in gynecological surgeries was calculated using standard parameters, including the cross-match-to-transfusion (C/T) ratio, transfusion probability (TP), and transfusion index (TI). Descriptive, univariate, and multivariate analyses were employed. Results: Of 2394 gynecological surgeries, 431 (18%) patients had cross-matching requests, while only 113 (4.7%) were transfused. Appropriate blood utilization was revealed by indices, with a C/T ratio of 2.43 and a TI of 0.60. 90.3% of transfusion events were administered in elective settings. Using univariable analysis, the data demonstrated that age, baseline hemoglobin, operative time, blood loss, previous abdominal surgeries, including myomectomy and endometriosis-related surgeries, cardiovascular comorbidities, and current antiplatelet/anticoagulant use were independently associated with perioperative blood transfusion. However, only three variables significantly remained on multivariable analysis, including baseline hemoglobin (adjusted odds ratio [aOR]: 0.608; 95% confidence interval [CI]: 0.519–0.709), operation duration (aOR: 1.004; 95% CI: 1.001–1.007), and blood loss (aOR 1.003; 95% CI: 1.003–1.004). Conclusion: The study reveals appropriate blood utilization in gynecological practices. Other than in cases of active hemorrhage or anticipated extensive surgery, routine cross-matching may be unnecessary in elective low-risk procedures. Tailored approaches are necessary for specific indications or procedures with a high likelihood of requiring blood transfusion.