Clinical Edge

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Risk of Blood Transfusion After Gynecologic Surgery

Am J Obstet Gynecol; ePub 2017 Jan 16; Stanhiser, et al

Selective preoperative testing and more efficient perioperative management utilization were the result of a model that accurately predicts a patient’s risk of blood transfusion after gynecologic surgery, a recent study found. The study included 18,319 women who underwent gynecologic surgery at 10 institutions between January 2010 and June 2014. A total of 47 candidate risk factors for transfusion were collected. Researchers found:

  • The transfusion rate in the training cohort (n=12,219 surgeries) was 2%.
  • The model showed excellent discrimination and calibration during internal validation and maintained accuracy during temporal validation using the separate validation cohort (n=6,100 surgeries).
  • Calibration curves demonstrated the model’s accuracy up to 40% before it began to over-predict risk.
  • Superior net benefit was observed when clinical decision thresholds were between 0% and 50% predicted risk.


Stanhiser J, Chagin K, Jelovsek JE, et al. A model to predict risk of blood transfusion after gynecologic surgery. [Published online ahead of print January 16, 2017]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2017.01.004