Department of Anesthesiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 An Zhen Road, Chaoyang District, Beijing, 100029, Beijing, China.
Department of Anesthesiology, Aerospace Center Hospital, Beijing, China.
Gen Thorac Cardiovasc Surg. 2020 Dec;68(12):1377-1387. doi: 10.1007/s11748-020-01386-3. Epub 2020 May 16.
The variables for predicting blood transfusion perioperatively are not completely clear in coronary artery bypass grafting (CABG) patients.
To construct a comprehensive model to predict perioperative RBC transfusion in patients undergoing isolated CABG using adjusted preoperative variables.
Perioperative data of 1253 patients who underwent isolated CABG by the same surgical team were collected from April 2018 to March 2019. Logistic regression analyses were used to establish equations to construct two models for predicting intraoperative and postoperative RBC transfusions, respectively. All significant variables included in the two models were combined to form a comprehensive model to predict perioperative RBC transfusion. Area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the discriminatory power of the models.
The total RBC transfusion rate for CABG patients during hospitalization was 29.05%. The rate of intraoperative and postoperative RBC transfusions was 6.9% and 26.7%, respectively. Eight variables in a total of 30 risk factors constituted the intraoperative prediction model, 12 variables constituted the postoperative prediction model, and 13 variables for the combined model. The AUC of the three models were 0.87, 0.82, and 0.83, respectively, demonstrating moderate discriminatory power for RBC transfusion during the intraoperative, postoperative, and perioperative periods.
The comprehensive model combined with all variables of predicting intraoperative and postoperative RBC transfusion is feasible for predicting perioperative RBC transfusion.
在冠状动脉旁路移植术(CABG)患者中,预测围手术期输血的变量尚不完全清楚。
使用调整后的术前变量,构建一个综合模型来预测接受单纯 CABG 的患者围手术期 RBC 输血。
收集了 2018 年 4 月至 2019 年 3 月期间由同一手术团队为 1253 例接受单纯 CABG 的患者的围手术期数据。采用逻辑回归分析分别建立方程,构建预测术中及术后 RBC 输血的两个模型。将两个模型中包含的所有显著变量组合在一起,形成一个综合模型,以预测围手术期 RBC 输血。采用接收者操作特征曲线(ROC)下面积(AUC)评价模型的鉴别能力。
CABG 患者住院期间总 RBC 输血率为 29.05%。术中及术后 RBC 输血率分别为 6.9%和 26.7%。共有 30 个风险因素中的 8 个变量构成了术中预测模型,12 个变量构成了术后预测模型,13 个变量构成了联合模型。三个模型的 AUC 分别为 0.87、0.82 和 0.83,表明在术中、术后和围手术期预测 RBC 输血的鉴别能力中等。
综合模型结合了预测术中及术后 RBC 输血的所有变量,可用于预测围手术期 RBC 输血。