Zhang et al reported a nomogram for predicting perioperative red blood cell transfusion in a patient undergoing surgery. The authors are from Central South University in China.
Patient selection: adult undergoing surgery
Parameters"
(1) age in years, >= 18
(2) race
(3) ASA performance status
(4) grade of kidney injury
(5) type of anesthesia
(6) priority of surgery
(7) surgery risk
(8) "18 level variables", based on RDW, anemia and MCV
|
Parameter |
Finding |
Points |
|
age in years |
18 to 29 years of age |
9 |
|
|
30 to 49 years of age |
0 |
|
|
50 to 69 years of age |
5.5 |
|
|
>= 70 years of age |
11 |
|
race |
Indian |
0 |
|
|
Malay |
3.8 |
|
|
Chinese |
7.8 |
|
|
other |
12.4 |
|
ASA performance status |
ASA 1 |
0 |
|
|
ASA 2 |
3.2 |
|
|
ASA 3 |
12.6 |
|
|
ASA 4 or 5 |
17.9 |
|
grade of kidney injury |
G1 |
6.4 |
|
|
G2 |
2.8 |
|
|
G3 |
5.9 |
|
|
G4 or G5 |
0 |
|
type of anesthesia |
regional |
0 |
|
|
general |
23.5 |
|
priority of surgery |
elective |
0 |
|
|
emergency |
4.8 |
|
surgery risk |
low |
0 |
|
|
moderate |
53.3 |
|
|
high |
86.7 |
|
RDW |
Anemia |
MCV |
18 Level |
Points |
|
normal |
normal |
normal |
0 |
0 |
|
|
|
low |
12 |
2.2 |
|
|
|
high |
11 |
16.4 |
|
|
mild anemia |
normal |
17 |
21.5 |
|
|
|
low |
8 |
21.5 |
|
|
|
high |
7 |
36.7 |
|
|
mod/severe anemia |
normal |
16 |
69.6 |
|
|
|
low |
6 |
60.7 |
|
|
|
high |
5 |
69.6 |
|
high |
normal |
normal |
13 |
18.5 |
|
|
|
low |
10 |
3 |
|
|
|
high |
9 |
6.3 |
|
|
mild anemia |
normal |
15 |
39 |
|
|
|
low |
4 |
24.8 |
|
|
|
high |
3 |
44.9 |
|
|
mod/severe anemia |
normal |
14 |
78 |
|
|
|
low |
2 |
76.6 |
|
|
|
high |
1 |
100 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 262.8
value of X =
= (0.0344 * (score)) - 6.642
risk of transfusion =
= 1 / (1 + EXP((-1) * X))
Performance:
• The C-index was 0.87.
Specialty: Clinical Laboratory
