Quan et al reported a nomogram for predicting the need for perioperative blood transfusion for a patient undergoing resection of hepatocellular carcinoma (HCC). The authors are from multiple institution from around the world.
Patient selection: partial hepatectomy for hepatocellular carcinoma
Parameters:
(1) ASA score
(2) cirrhosis
(3) hemoglobin in g/dL
(4) INR
(5) serum total bilirubin in mg/dL
(6) maximum tumor diameter in cm
(7) tumor number
(8) planned extent of the hepatectomy
points for hemoglobin =
= 143.75 - (7.1877 * (hemoglobin))
points for tumor size =
= 4.5454 * (diameter)
Parameter
Finding
Points
ASA score
0 to 2
0
3 to 5
15.47
cirrhosis
no
0
yes
19.53
INR
< 1.25
0
>= 1.25
25.78
serum bilirubin
<= 1.0 mg/dL
0
1.1 to 1.9
21.88
>= 2.0
48.44
tumor number
1
0
>= 2
18.75
extent of hepatectomy
< 3 segments (minor)
0
>= 3 segments (major)
23.44
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 344.84
Score
Probability of Perioperative Blood Transfusion
< 33.7
< 1%
33.7 to 227.5
X = (0.038972 * (score)) - 5.8728
probability = 1/(1 + EXP((-1) * X))
> 227.5
> 95%
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