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Cardiac Surgery Patient Transfusion Risk Understanding Scoring Tool (TRUST)

Purpose: To evaluate a cardiac surgery patient for the risk of needing a blood transfusion using the Transfusion Risk Understanding Scoring Tool (TRUST).

Description

Alghamdi et al developed the Transfusion Risk Understanding Scoring Tool (TRUST) for identifying cardiac surgery patients who may need blood transfusion. This can help identify patients who may be candidates for preventive measures to reduce the need for transfusion. The authors are from the University of Toronto.


Parameters:

(1) age

(2) gender

(3) preoperative hemoglobin

(4) body weight in kilograms

(5) elective surgery

(6) serum creatinine

(7) history of previous cardiac surgery

(8) surgical task (isolated vs nonisolated)

 

Parameter

Finding

Points

age of the patient in years

<= 65 years

0

 

> 65 years

1

gender

male

0

 

female

1

hemoglobin

>= 13.5 g/dL

0

 

< 13.5 g/dL

1

body weight in kilograms

>=77 kilograms

0

 

< 77 grams

1

elective surgery

yes

0

 

no (nonelective)

1

serum creatinine

<= 1.36 mg/dL (120 µmol/L)

0

 

> 1.36 mg/dL (120 µmol/L)

1

history of previous cardiac surgery

no

0

 

yes

1

surgical task

isolated

0

 

nonisolated (CABG + valve replacement, etc

1

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 8

• The higher the score the greater the probability of requiring a blood transfusion.

 

Total Score

Risk Group

Probability of Transfusion

0

baseline risk

< 20%

1

low risk

20 - 39%

2

intermediate risk

40 - 59%

3

high risk

60 - 79%

4 to 8

very high risk

80 - 100%

 

X =

= (0.8377 * (total score)) - 1.9503

 

probability of blood transfusion =

= 1 / (1 + EXP((-1) * X))


 


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Specialty

Objective

ICD-10