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Risk factors for perioperative blood transfusions after urogenital fistula repair in Uganda: a retrospective cohort study
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  • Thrisha Potluri,
  • Lauren Holt,
  • Jean Paul Tanner,
  • Lucien Wasingya,
  • Shane Duffy,
  • Kristie Greene
Thrisha Potluri
University of South Florida College of Medicine
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Lauren Holt
University of South Florida College of Medicine
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Jean Paul Tanner
University of South Florida College of Public Health
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Lucien Wasingya
Kitovu Hospital
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Shane Duffy
Chelsea and Westminster Hospital
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Kristie Greene
University of South Florida College of Medicine
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Abstract

Objective: To determine the incidence of and risk factors for perioperative blood transfusions after urogenital fistula repairs in Uganda. Design: A retrospective cohort study. Setting: A community hospital in Masaka, Uganda. Population: Women who underwent fistula repair at the Kitovu Hospital between 2013 and 2019. Methods: Retrospective review of demographics, and clinical perioperative characteristics of patients surgically treated for urogenital fistula. Patient characteristics were compared between those who did and did not require a blood transfusion. Main Outcome Measures: need for perioperative blood transfusion, risk factors Results: 546 patients treated for urogenital fistulas were included in this study. The median age was 31.1 ± 13.2. A vaginal surgical approach was used in the majority of patients (84.6%). Complications occurred in 3.5% of surgical repairs, and the incidence of blood transfusions was 6.2%. In multivariable analyses, women with fistula repairs approached abdominally were 4.3 (95% CI: 1.85–10.00) times more likely to require transfusions than vaginal operations. A borderline association was observed between timing of repair and perioperative transfusions such that patients who underwent repair after three months from the time of developing the fistula were at lower risk of perioperative transfusions (aOR: 0.48, 95% CI: 0.22–1.04). Conclusions: The incidence of blood transfusions among urogenital fistula repairs in our population is twice that of developed nations. An abdominal surgical approach to urogenital fistula is a significant risk factor for perioperative blood transfusions. Timing of repair may warrant further study.

Peer review status:UNDER REVIEW

21 Jan 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
27 Jan 2021Submission Checks Completed
27 Jan 2021Assigned to Editor
28 Feb 2021Reviewer(s) Assigned
07 Mar 2021Review(s) Completed, Editorial Evaluation Pending
03 Apr 2021Editorial Decision: Revise Major
08 May 20211st Revision Received
10 May 2021Submission Checks Completed
10 May 2021Assigned to Editor
10 May 2021Review(s) Completed, Editorial Evaluation Pending
22 May 2021Editorial Decision: Revise Minor
11 Jun 20212nd Revision Received
17 Jun 2021Assigned to Editor
17 Jun 2021Submission Checks Completed
17 Jun 2021Review(s) Completed, Editorial Evaluation Pending