Rashiq et al developed a score for predicting the need for blood transfusion for a patient undergoing a total joint arthroplasty. These factors are known prior to surgery and can identify who may require more aggressive blood conservation. The authors are from the University of Alberta in Canada.
Patient selection: hip or knee joint replacement surgery
Preoperative parameters:
(1) age in years
(2) gender
(3) body weight in kilograms
(4) hemoglobin in g/dL
(5) ASA classification
(6) revision surgery
|
Parameter |
Finding |
Points |
|---|---|---|
|
age in years |
< 65 years of age |
0 |
|
|
65 to 79 years of age |
20 |
|
|
>= 80 years of age |
30 |
|
gender |
male |
0 |
|
|
female |
20 |
|
body weight |
<= 60 kilograms |
65 |
|
|
61 to 70 kg |
40 |
|
|
71 to 80 kg |
25 |
|
|
81 to 90 kg |
20 |
|
|
> 90 kg |
0 |
|
hemoglobin |
<= 120 g/L |
140 |
|
|
121 to 130 g/L |
95 |
|
|
131 to 140 g/L |
40 |
|
|
141 to 150 g/L |
35 |
|
|
> 150 g/L |
0 |
|
ASA classification |
I or II |
0 |
|
|
III, IV or V |
15 |
|
revision surgery |
no |
0 |
|
|
yes |
25 |
where:
• There probably are not many total joint replacements in someone with ASA Class IV or V.
• Some people would use different cutoffs for hemoglobin based on gender.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 295
• The higher the score the greater the likelihood of allogeneic blood transfusion.
|
Total Score |
Probability |
|
<= 100 |
<= 10% |
|
101 to 150 |
10 to 30% |
|
151 to 200 |
30 to 50% |
|
201 to 295 |
> 50% |
Performance:
• The area under the ROC curve is 0.80.
Purpose: To identify the need for blood transfusion for a patient undergoing total joint replacement based on the prediction rule of Rashiq et al.
Specialty: Clinical Laboratory, General Surgery, Anesthesiology, Emergency Medicine, Critical Care
Objective: criteria for diagnosis, severity, prognosis, stage, complications, selection
ICD-10: D62, Z51.3, I97,
