Litmathe et al identified factors that may predict blood transfusion in a patient undergoing open heart surgery. These can help to identify a patient who may benefit from blood-preserving strategies. The authors are from Heinrich Heine University in Duesseldorf.
Patient selection: open heart surgery for coronary artery bypass grafting (CABG)
Parameters:
(1) age in years
(2) gender
(3) preoperative hemoglobin in g/dL
(4) left ventricular ejection fraction (LVEF) in percent
(5) insulin-dependent diabetes mellitus
(6) renal function based on serum creatinine in mg/dL
(7) timing of the surgery
(8) reoperation (history of previous cardiac surgery)
|
Parameter |
Finding |
Points |
|
age of the patient in years |
<= 70 years of age |
0 |
|
|
> 70 years of age |
1 |
|
gender |
male |
0 |
|
|
female |
1 |
|
preoperative hemoglobin |
>= 11 g/dL |
0 |
|
|
< 11 g/dL |
3 |
|
LVEF in percent |
>= 35% |
0 |
|
|
< 35% or cardiogenic shock |
3 |
|
insulin-dependent diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
serum creatinine |
<= 1.6 mg/dL |
0 |
|
|
> 1.6 mg/dL |
1 |
|
timing of the surgery |
elective |
0 |
|
|
urgent |
2 |
|
|
emergency |
4 |
|
reoperation |
no |
0 |
|
|
yes |
2 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the more likely that the patient will require a blood transfusion.
Specialty: Clinical Laboratory, General Surgery, Anesthesiology, Emergency Medicine, Critical Care
