Klein et al reported a score for predicting perioperative blood transfusion for an adult undergoing cardiac surgery. The authors are from multiple institutions in the United Kingdom and Australia with membership in the Association of Cardiothoracic Anaesthesia and Critical Care.
ACTA = Association of Cardiothoracic Anaesthetists
PORT = perioperative risk of transfusion
Patient selection: adult cardiac surgery
Parameters:
(1) age in years
(2) sex
(3) hemoglobin in g/L
(4) body surface area (BSA) in square meters
(5) EuroSCORE (from 0 to around 45)
(6) serum creatinine in µmol/L
(7) type of operation
|
Parameter |
Finding |
Points |
|
age in years |
< 70 years |
0 |
|
|
>= 70 years |
1 |
|
sex |
male |
0 |
|
|
female |
1 |
|
hemoglobin |
< 110 g/L |
9 |
|
|
110 to 119.9 |
8 |
|
|
120 to 129.9 |
6 |
|
|
130 to 139.9 |
3 |
|
|
140 to 149.9 |
2 |
|
|
>= 150 |
0 |
|
BSA |
< 1.7 square meters |
6 |
|
|
1.7 to 1.89 |
4 |
|
|
1.9 to 2.09 |
2 |
|
|
2.1 to 2.29 |
1 |
|
|
>= 2.3 |
0 |
|
EuroSCORE |
< 1 |
0 |
|
|
1.0 to 1.9 |
2 |
|
|
2.0 to 2.9 |
3 |
|
|
3.0 to 8.9 |
4 |
|
|
>= 9.0 |
5 |
|
serum creatinine |
< 88 µmol/L |
0 |
|
|
88 to 176.9 |
1 |
|
|
>= 177 |
3 |
|
type of operation |
CABG or valve |
2 |
|
|
combination |
5 |
|
|
other |
0 |
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
• The higher the score the greater the risk of blood transfusion.
|
Total Score |
Predicted Risk of Transfusion |
|
0 |
4.7% |
|
1 |
5.7% |
|
2 |
6.9% |
|
3 |
8.3% |
|
4 |
10% |
|
5 |
11.9% |
|
6 |
14.2% |
|
7 |
16.8% |
|
8 |
19.8% |
|
9 |
23.1% |
|
10 |
26.9% |
|
11 |
31% |
|
12 |
35.4% |
|
13 |
40.1% |
|
14 |
45% |
|
15 |
50% |
|
16 |
55% |
|
17 |
59.9% |
|
18 |
64.6% |
|
19 |
69% |
|
20 |
73.1% |
|
21 |
76.9% |
|
22 |
80.2% |
|
23 |
83.2% |
|
24 |
85.8% |
|
25 |
88.1% |
|
26 |
90% |
|
27 |
91.7% |
|
28 |
93.1% |
|
29 |
94.3% |
|
30 |
95.3% |
Performance:
• The area under the ROC curve is 0.84.
Specialty: Clinical Laboratory, Surgery, general, Surgery, orthopedic
