Cockbain et al developed a risk score for blood transfusion requirements during elective liver resection. This can aid perioperative planning. The authors are from St. James's University Hospital in Leeds, England.
Patient selection: elective liver resection
Parameters:
(1) coronary artery disease (CAD)
(2) preoperative biliary drainage
(3) redo resection
(4) tumor diameter in centimeters
(5) hemoglobin in g/dL
(6) number of segments resected
(7) histologic diagnosis
Parameter
Finding
Points
coronary artery disease
absent
0
present
1
preoperative biliary drainage
no
0
yes
1
redo resection
no
0
yes
1
tumor diameter
<= 3.5 cm
0
> 3.5 cm
1
hemoglobin
>= 12.5 g/dL
0
< 12.5 g/dL
1
number of segments resected
1 to 4
0
>= 5
1
histologic diagnosis
cholangiocarcinoma
1
other
0
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the likelihood of blood transfusion.
Total Score
Percent Transfused
0
4%
1
9%
2
18%
3
42%
4
80%
5
100%
Performance:
• The area under the ROC curve was 0.77.
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