Ahmadzia et al reported models for predicting the risk of peripartum blood transfusion for a woman having a cesarean delivery. One model is for antepartum evaluation. The authors are from George Washington University and Duke University.
Patient selection: woman having a cesarean delivery
Parameters:
(1) age in years
(2) body mass index (BMI)
(3) platelet count in 10^9/L
(4) hematocrit in percent
(5) gestational hypertension or pre-eclampsia
(6) HELLP
(7) history of asthma
(8) abruption
(9) race
(10) insurance
(11) gestational age in weeks
(12) number of previous term deliveries
(13) number of previous cesarean deliveries
(14) heart disease
|
Parameter |
Finding |
Points |
|
age |
< 21 years |
0.2301 |
|
|
21 to 36 years |
0 |
|
|
> 36 years |
0.2301 |
|
body mass index |
|
-0.0138 * (BMI) |
|
platelet count |
< 150 * 10^9/L |
0.5708 |
|
|
>= 150 * 10^9/L |
0 |
|
hematocrit |
< 32 percent |
1.3125 |
|
|
>= 32 percent |
0 |
|
blood pressure disorder |
none |
0 |
|
|
pre-eclampsia |
0.2065 |
|
|
gestational hypertension |
0.2065 |
|
HELLP |
no |
0 |
|
|
yes |
1.1069 |
|
history of asthma |
no |
0 |
|
|
yes |
0.1496 |
|
abruption |
no |
0 |
|
|
yes |
1.1821 |
|
race |
African American |
0.2369 |
|
|
other |
0 |
|
insurance |
none |
0.4107 |
|
|
Medicaid or Medicare |
0.3122 |
|
|
other |
0 |
|
gestational age in weeks |
< 37 weeks |
0.6127 |
|
|
>= 37 weeks |
0 |
|
number of previous term deliveries |
< 3 |
0 |
|
|
>= 3 |
0.6538 |
|
previous cesarean deliveries |
0 |
0.4439 |
|
|
1 |
0 |
|
|
2 |
0.3029 |
|
|
>= 3 |
0.4526 |
|
heart disease |
no |
0 |
|
|
yes |
0.7678 |
X =
= SUM(points for all 14 parameters) - 4.6841
probability of transfusion =
= 1 / (1 + EXP((-1) * X))
Specialty: Clinical Laboratory, Obstetrics & Gynecology
