Introduction
Transfusion of red blood cells is recurrent in cardiac surgery despite the
well-established deleterious effects. Identifying patients with higher
chances of requiring blood transfusion is essential to apply strategic
preventive measures to reduce such chances, considering the restricted
availability of this product. The most used risk scores to predict blood
transfusion are the Transfusion Risk and Clinical Knowledge (TRACK) and
Transfusion Risk Understanding Scoring Tool (TRUST). However, these scores
were not validated for the Brazilian population. The objective of this study
was to assess the accuracy of TRACK and TRUST scores in estimating the need
for postoperative transfusion of red blood cell concentrates (TRBCC) after
cardiac surgery.
Methods
A clinical retrospective study was conducted using the database of a
Brazilian reference service composed of patients operated between November
2019 and September 2021. Scores were compared using Mann-Whitney U test.
Hosmer-Lemeshow goodness of fit test assessed calibration of the scores.
Accuracy was assessed using the area under the receiver operating
characteristic curve (AUC). All analyses considered a level of significance
of 5%. The study was approved by the research ethics committee (CAAE
55577421.4.0000.5201).
Results
This study assessed 498 patients. Only the TRACK score presented good
calibration (P=0.238; TRUST P=0.034). AUC of TRACK was 0.678 (95% confidence
interval 0.63 to 0.73; P<0.001), showing a significant accuracy.
Conclusion
Between the scores analyzed, only the TRACK score showed a good calibration,
but low accuracy, to predict postoperative TRBCC after cardiac surgery.