Model of Savan et al for Predicting Postoperative Blood Loss and Transfusion Associated Following Cardiac Surgery in Pediatric Patients with Congenital Heart Disease
Savan et al developed a model for predicting significant postoperative bleeding in a pediatric patient undergoing cardiac surgery for congenital heart disease. This can help to identify a patient who may need blood transfusions. The authors are from State Medical and Pharmaceutical University of Moldova and Queen Fabiola Children's University Hospital in Brussels.
Patient selection: pediatric patient with congenital heart disease undergoing cardiac bypass surgery (age range 1.8 to 40 months)
Parameters:
(1) cyanotic heart disease
(2) wound closure duration in minutes
(3) body weight in kilograms
Parameter
Finding
Points
cyanotic heart disease
no
0
yes
1.12
wound closure duration
0.04 * (time)
body weight
-0.22 * (weight)
where:
• Wound closure is not specifically defined. Times ranged from 57 to 100 minutes. It was considered prolonged if > 64 minutes.
X =
= SUM(points for all 3 parameters) - 1.3
probability of bleeding =
= 1 / (1 +EXP((-1) * X))
A probability >= 59% was associated with >= 10% loss of expected blood volume in the first 6 hours after surgery (criteria for clinically significant bleeding). At this cutoff the sensitivity was 84% and specificity 64%.
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