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CME Credit Offered
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Abstract Award
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Poster Session 3

(897) Transfer Status and Severe Hemorrhage Risk in Cesarean Section Patients

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Reetam Ganguli, BS

    Elythea
    San Jose, CA, United States

    • Coauthor(s)

  • JW

    Joshua Woo, BS

    Warren Alpert Medical School, Brown University
    Providence, Rhode Island, United States

  • AL

    Alice Lin, BS

    Warren Alpert Medical School, Brown University
    Providence, Rhode Island, United States

  • MA

    Maguire Anuszewski, BS

    Warren Alpert Medical School, Brown University
    Providence, Rhode Island, United States

  • Julia Sroda Agudogo, MD

    Beth Israel Deaconess Medical Center
    Boston, Massachusetts, United States

  • SW

    Stephen Wagner, MD

    Beth Israel Deaconess Medical Center
    Boston, Massachusetts, United States

Objective:

Transfer status influences severe hemorrhage risk in cesarean section patients, highlighting the importance of tailored preoperative management strategies to mitigate complications. This study evaluated the association between transfer indications and severe hemorrhage necessitating transfusion in patients undergoing cesarean sections.

Study Design: A retrospective cohort study was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from January 2009 to December 2021. Included were patients undergoing cesarean sections identified by Current Procedural Terminology (CPT) codes 59510, 59514, 59515, 59618, 59620, and 59622. Exclusion criteria included missing data for the outcome variable indicating severe hemorrhage necessitating transfusion. Chi-square tests determined statistical significance, and odds ratios (OR) with 95% confidence intervals (CI) quantified the risk of severe hemorrhage for patients with different transfer statuses compared to patients who were not transferred.

Results:

 In our cohort of 43,713 patients, 61.27% were not transferred (admitted from home). Transfers from home/permanent residence had a significantly lower risk of severe hemorrhage (OR = 0.755, 95% CI: 0.677-0.842, p < 0.001). Conversely, transfers from outside emergency departments (OR = 4.307, 95% CI: 2.057-9.020, p < 0.001) and other facilities (OR = 5.653, 95% CI: 1.263-25.302, p = 0.079) exhibited markedly higher risk. Acute care hospital transfers were also associated with a significantly lower risk of severe hemorrhage (OR = 0.336, 95% CI: 0.218-0.517, p < 0.001). Transfers from acute care hospital inpatient and unknown transfer reasons did not show statistically significant differences.

Conclusion:

Cesarean deliveries transferred from outside emergency departments and other facilities are at higher hemorrhage risk, making enhanced preoperative management vital. These findings emphasize considering transfer status in risk stratification and preoperative planning to mitigate hemorrhage risks in cesarean section patients.