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首页> 外文期刊>Vox Sanguinis: International Journal of Blood Transfusion and Immunohaematology >Predicting transfusions in cardiac surgery: the easier, the better: the Transfusion Risk and Clinical Knowledge score.
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Predicting transfusions in cardiac surgery: the easier, the better: the Transfusion Risk and Clinical Knowledge score.

机译：预测心脏手术中的输血：越容易越好：输血风险和临床知识得分。

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摘要

BACKGROUND AND OBJECTIVES: Allogeneic blood products 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 and validate a risk score based on adequate statistical analyses joint with a clinical selection of a limited (five) number of preoperative predictors. MATERIALS AND METHODS: The development series was composed of 8989 consecutive adult patients undergone cardiac surgery. Independent predictors of allogeneic blood transfusions were identified. Subsequently, five predictors were extracted as the most clinically relevant based on the judgement of 30 clinicians dealing with transfusions in cardiac surgery. A predictive score was developed and externally validated on a series of 2371 patients operated in another institution. The score was compared to the other existing scores. RESULTS: The following predictors constituted the Transfusion Risk and Clinical Knowledge score: age > 67 years; weight < 60 kg for females and < 85 kg for males preoperative haematocrit; gender--female; and complex surgery. At the external validation, this score demonstrated an acceptable predictive power (area under the curve 0.71) and a good calibration at the Hosmer-Lemeshow test. When compared to the other three existing risk scores, the Transfusion Risk and Clinical Knowledge score had comparable or better predictive power and calibration. CONCLUSION: A simple risk model based on five predictors only has a similar or better accuracy and calibration in predicting the transfusion rate in cardiac surgery than more complex models.
机译：背景与目的：异体血液制品的输注与心脏手术中发病率和死亡风险的增加有关。目前，已经提出了一些针对心脏手术患者的输血危险评分。本研究旨在基于适当的统计分析以及有限（五）种术前预测因素的临床选择，制定和验证风险评分。材料与方法：该开发系列由8989名连续接受心脏手术的成年患者组成。确定了同种异体输血的独立预测因子。随后，根据30位从事心脏外科手术输血的临床医生的判断，提取了5个与临床最相关的预测因子。对在另一家机构接受手术的2371名患者进行了预测评分并进行了外部验证。将该分数与其他现有分数进行比较。结果：以下预测因素构成了输血风险和临床知识得分：年龄> 67岁;体重<60 kg，女性<85 kg，男性性别女;和复杂的手术。在外部验证中，该分数显示出可接受的预测能力（曲线下面积0.71），并且在Hosmer-Lemeshow测试中具有良好的校准效果。与其他三个现有风险评分相比，输血风险和临床知识评分具有可比或更好的预测能力和校准能力。结论：基于五种预测因素的简单风险模型在预测心脏手术中的输血率方面仅具有比更复杂的模型相似或更好的准确性和校准。

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