Department of Anaesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Am J Surg. 2013 Sep;206(3):326-32. doi: 10.1016/j.amjsurg.2012.11.016. Epub 2013 May 28.
Although there has been growing evidence from off-label use of recombinant activated factor VII (rFVIIa) in surgical bleeding, there is limited information on prediction scores.
A retrospective study was conducted from 2004 to 2009. The primary outcome was efficacy of bleeding control. Multivariate logistic regression was performed to develop a new prediction score for success of rFVIIa.
A total of 320 bleeding episodes from 243 nonhemophilic patients who underwent surgery were analyzed. Effective bleeding control was demonstrated in 153 patients. The overall in-hospital mortality rate was 40%. Multivariate analysis identified 4 independent predictors for effective bleeding control: timing of rFVIIa administration, intraoperative blood loss, postoperative international normalization ratio values, and total units of platelets transfused. A rFVIIa success prediction score was developed.
The use of this new prediction score may support decision making by identifying patients with a high probability of obtaining effective bleeding control from rFVIIa therapy.
尽管重组活化因子 VII（rFVIIa）在手术出血中的非适应证使用已有越来越多的证据，但关于预测评分的信息有限。
本研究为 2004 年至 2009 年的回顾性研究。主要结局是出血控制的疗效。采用多变量逻辑回归建立 rFVIIa 成功的新预测评分。
共分析了 243 例非血友病患者手术中 320 次出血事件。153 例患者出血得到有效控制。总的院内死亡率为 40%。多变量分析确定了 4 个独立的出血控制有效预测因子：rFVIIa 给药时机、术中失血量、术后国际标准化比值值和血小板总输血量。开发了 rFVIIa 成功预测评分。
使用这个新的预测评分可以通过识别出 rFVIIa 治疗出血控制有效可能性高的患者，从而支持决策制定。
