Evaluation of risk scores in predicting perioperative blood transfusions in adult cardiac surgery

Abstract

Objective: Allogeneic blood product transfusions are associated with an increased morbidity and mortality risk in cardiac surgery. At present, a few transfusion risk scores have been proposed for cardiac surgery patients. The present study is aimed to develop a new score and to compare with preexisting scores – Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST) score. Methodology: A total of 1014 adult patients undergoing cardiac surgery were enrolled in the retrospective study. Independent predictors of allogeneic blood transfusions were selected from TRACK and TRUST scores. A predictive score was developed from six variables using logistic regression analysis, and new score was compared to the other existing scores – TRACK and TRUST. Results: The new score had following predictors: age >58 years, weight <63 kg for males and <49 kg for females, gender (female), complex surgery, hemoglobin <13.5 g/dl, and creatinine >1.36 mg/dl. Validation of new score demonstrated an acceptable predictive power (area under the curve [AUC] 0.749) and a good calibration at the Hosmer–Lemeshow test. New score was comparable with TRACK score with P = 0.578 (AUC of TRACK 0.756 and AUC of new score 0.749). There was a significant difference between new score and TRUST score, P = 0.01 (AUC of TRUST 0.72 and AUC of new score 0.749). Conclusion: New score is a simple risk model based on six predictors having a similar accuracy and calibration in predicting the transfusion rate in cardiac surgery as compared to TRACK score.

Approaches on the Major Predictors of Blood Transfusion in Cardiovascular Surgery: A Systematic Review

“…Thus, one study developed a new score and compared it with preexisting scores-transfusion risk score and clinical knowledge (TRACK) and TRUST score (Scoring Understanding Scoring Tool) [3]. A total of 1014 adult patients undergoing cardiac surgery were included in the retrospective study.…”

“…There was a significant difference between the new score and the TRUST score, p = 0.01 (AUC of TRUST 0.72 and AUC of the new score 0.749). The new score is a simple risk model based on six predictors with similar accuracy and calibration in predicting the rate of transfusion in cardiac surgery when compared to the TRACK score [3].…”

“…Currently, some transfusion risk scores have been proposed for cardiac surgery patients. In other Western countries, it is the third cause of death after cardiovascular diseases and cancers, and those below 45 years of age, the leading cause of death [3]. According to the Ministry of Health, there were 127,633 deaths from trauma in Brazil in 2005, representing 12.67% of total deaths.…”

“…According to the Ministry of Health, there were 127,633 deaths from trauma in Brazil in 2005, representing 12.67% of total deaths. In December 2015, there were 86,583 hospitalizations for trauma in the country [3].…”

Evaluation of a novel Cardiac Peri-Operative Transfusion Trigger Scoring system in patients with coronary artery disease

“…Cardiovascular disease (CVD) is the number one cause of death globally and has become one of the most important diseases and public health problems in the twenty-first century [ 1 ]. The number of patients undergoing cardiac surgery is also increasing yearly, and these patients are more susceptible to the consequences of perioperative anemia [ 2 ]. Perioperative anemia in patients with CVD is independently associated with a significantly increased risk of postoperative mortality and major complications [ 3 – 7 ].…”