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 |
Specialty: Clinical Laboratory, Surgery, general, Anesthesiology, Emergency Medicine, Critical Care
