Blood loss assessment in abdominal hysterectomy: how accurate?

Authors

  • Virupaksha Ajjammanavar Department of OBG, JSS Medical College, JSS University, Mysore, Karnataka, India
  • Jayashree S. Department of OBG, JSS Medical College, JSS University, Mysore, Karnataka, India
  • Amrutha B. Department of OBG, JSS Medical College, JSS University, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20160361

Keywords:

Abdominal hysterectomy, Estimated blood loss, Actual blood loss

Abstract

Background: Precise estimation of blood loss is the key to optimal transfusion practice in surgery. Many studies done in various fields of surgery infer that clinical assessment of blood loss by the surgeon or anesthesiologist is inaccurate. The purpose of this study is to see if there is any difference in visual estimation of blood loss and actual blood loss calculated using modification of gross formula in abdominal hysterectomy.

Methods: Fifty four patients undergoing total abdominal hysterectomy for various indications at JSS Hospital, Mysore were included in the study. Baseline characteristics, pre-operative haematocrit, clinically estimated blood loss (EBL) and post-operative haematocrit were noted. Actual blood loss (ABL) was calculated from a modification of the Gross formula. The number of cases where the blood loss was clinically underestimated and overestimated; and the relationship between the difference in actual and estimated blood loss and accuracy of clinical assessment of blood loss was determined. The data obtained was analysed using descriptive statistics and Crammer’s V test.

Results: In the 54 cases of abdominal hysterectomy which we studied, there was overestimation of blood loss in 28 (51.9%) cases and underestimation of blood loss in 26 (48.1%) cases. The more the inaccuracy in clinical assessment of blood loss, more was the possibility of clinicians underestimating the blood loss.

Conclusions: Clinical estimation of blood loss is an inaccurate method of assessing blood loss in abdominal hysterectomy.

References

Mc Swiney MM, O’Farrell D, Joshi GP, Mc Carroll SM. Blood Transfusion in Total Hip Athroplasty: guidelines to eliminate over transfusion. Can J Anaesth. 1993;40(3): 222-26.

Naveen Eipe, Manickam Ponniah. Perioperative blood loss assessment – How accurate? Indian J Anaesth. 2006;50(1):35-8.

Ganesan R, P Suresh, Phagal Varthi V. Surgeons often underestimate the amount of blood loss in replacement surgeries. Chinese J Traumatol. 2014;17(4):225-8.

Brecher M, Monk T, Goodnough L. A Standardized method for calculating blood loss, Transfusion. 1997;37:1070-74.

Lee MH, Ingvertsen BT, Kirpensteign J, Jensen AL. Quantification of Surgical Blood Loss. Vet Surg. 2006;35:388-93.

Gross JB. Estimating allowable blood loss: corrected for dilution. Anesthesiol. 1983;58(3):277-80.

Thornton JA, Saynor R, Schroeder HG, Taylor DG, Verel D. (1963) Estimation of blood loss with particular reference to cardiac surgery: description of a method. British J Anaesth. 1963;35:91-9.

Howe C, Paschall C, Panwalker A, Beal J. A model for clinical estimation of perioperative hemorrhage. Clin Appl Thrombosis/Hemostasis. 2003;9(2):131-5.

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Published

2016-12-17

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Section

Original Research Articles