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Transfusion Prediction Model of Krupp et al for a Patient Undergoing Head and Neck Cancer Surgery

Description

Krupp et al developed a prediction model for patients undergoing head and neck cancer surgery. This can help to identify a patient who is likely to need blood transfusion based on preoperative status and the operative plan. The authors are from the University of Pennsylvania.


 

Outcome: perioperative blood transfusion (transfusion during or within 30 days of surgery)

 

Parameters:

(1) preoperative anemia (hemoglobin < 14 g/dL if male; < 12 g/dL if female)

(2) T code for tumor stage

(3) flap reconstruction

Parameter

Finding

Points

preoperative anemia

absent

0

 

present

1

T code

T1 or T2

0

 

T3 or T4

1

flap reconstruction

no

0

 

yes

1

 

X by first original model =

= (1.71 * (points for anemia)) + (0.715 * (points for tumor stage)) + (2.12 * (points for flap)) - 3.989

 

X by second model =

= (0.174 * (points for anemia)) + (0.389 * (points for tumor stage)) + (1.609 * (points for flap)) - 2.378

 

probability of perioperative blood transfusion =

= 1 / (1 + EXP((-1) * X))

 

The authors also looked at the actual need for blood transfusion for the 8 combinations of these findings.

 

Flap

Anemia

T Code

Need for Transfusion

N

N

N

low (< 10%)

N

N

Y

low

N

Y

N

low

N

Y

Y

intermediate (15-20%)

Y

N

N

intermediate

Y

N

Y

high (>= 40%)

Y

Y

N

high

Y

Y

Y

high

 


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