Premium
Predicting blood loss and transfusion requirement in patients undergoing surgery for musculoskeletal tumors
Author(s) -
Thompson Philip A.,
May Deborah,
Choong Peter F.,
Tacey Mark,
Liew Danny,
ColeSinclair Merrole F.
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12532
Subject(s) - medicine , logistic regression , blood transfusion , psychological intervention , blood product , referral , surgery , odds ratio , emergency medicine , family medicine , psychiatry
Background Few studies have systematically identified factors associated with blood loss in musculoskeletal tumor surgery. We aimed to identify risk factors for requiring large‐volume transfusion in musculoskeletal tumor surgery and created an interactive model to predict red blood cell transfusion requirements based on patient characteristics. These data will facilitate planning in hospital blood banks and aid identification of specific groups for future interventions targeted at reducing blood utilization. Only one similar study has been published and there are minimal data surrounding interventions designed to minimize blood loss in musculoskeletal tumor surgery. Study Design and Methods We retrospectively analyzed a database containing 1322 consecutive surgeries, performed at a quaternary referral center in M elbourne, A ustralia. Using logistic regression analysis and a negative truncated binomial logistic regression model, we developed prediction models for transfusion requirement. Results The following factors were associated with large‐volume transfusion: malignant tumors, bone tumors, sacral and pelvic tumors, high A merican S ociety of A nesthesiologists ( ASA ) score, and tumor size of more than 5 cm. High ASA score was also strongly associated with 30‐day mortality. Conclusions Preoperative planning in high‐risk patients is critical to ensure adequate blood product supply, minimize wastage, and optimize the patient's general health before surgery. These patients would be ideal targets for future randomized studies aimed at reducing blood utilization.