Transfusion Risk Score (TRS) of Pulitano et al for Perioperative Blood Transfusion in a Patient Undergoing Liver Surgery

Description

Pulitano et al developed the transfusion risk score (TRS) to help to identify a patient undergoing liver surgery who may require perioperative blood transfusion. This can help to identify a patient who may benefit from more aggressive management. The authors are from Vita-Salute San Raffaele University in Milan.

Patient selection: liver surgery with or without extrahepatic procedures

Outcome: perioperative blood transfusion

Parameters:

(1) preoperative hemoglobin concentration

(2) maximum tumor size in cm

(3) need to expose the vena cava

(4) need for an associated (non-hepatic, vascular) procedure

(5) cirrhosis

Parameter	Finding	Points
preoperative hemoglobin	>= 12.5 g/dL	0
	< 12.5 g/dL	1
maximum tumor size	none or <= 4 cm	0
	> 4 cm	1
need to expose vena cava	no	0
	yes	1
associated procedure	no	0
	yes	1
cirrhosis	absent	0
	present	1

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the more likely that the patient will be transfused.

Score	Percent Transfused
0 or 1	3-5%
2	42-52%
3	75-86%
4	83 to 95%
5	100%

based on ranges in derivation and internal validation groups

Performance:

• The area under the ROC curve was 0.89.

• Janny et al found that the TRS did not perform as well as the authors did, with an AUC of 0.68.

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Transfusion Risk Score (TRS) of Pulitano et al for Perioperative Blood Transfusion in a Patient Undergoing Liver Surgery

Description

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