Chen Dong Xu, Wang Yi Shun, Yan Min, Du Lei, Li Qian
Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan 610041, P.R.China.
The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan 610041, P.R.China.
iScience. 2023 Sep 1;26(10):107798. doi: 10.1016/j.isci.2023.107798. eCollection 2023 Oct 20.
Perioperative blood transfusion is costly and raises safety concerns. We developed and validated a model for predicting minor, moderate, or major transfusion given to patients during on-pump cardiac procedures based on two centers' database. Model performance incorporating 7 variables on the development set had an AUC of 0.803 [95% CI, 0.790-0.815] for minor transfusion; moderate transfusion, giving an AUC of 0.822 (95% CI, 0.803-0.841); and major transfusion, giving an AUC of 0.813 (95% CI, 0.759-0.866). Model performance on the validation set had an AUC of 0.739 (95% CI 0.714-0.765), 0.730 (95% CI 0.702-0.758), and 0.713 (95% CI 0.677-0.749), respectively. A model based entirely on readily available electronic health records can accurately predict intraoperative minor, moderate, or major transfusion and provide individualized transfusion risk profiles before surgery among those on-pump cardiac surgical patients, and may help guide patient management.
围手术期输血成本高昂且引发安全担忧。我们基于两个中心的数据库开发并验证了一个模型，用于预测在体外循环心脏手术期间给予患者的少量、中度或大量输血情况。在开发集上纳入7个变量的模型性能，对于少量输血，AUC为0.803 [95%置信区间，0.790 - 0.815]；对于中度输血，AUC为0.822（95%置信区间，0.803 - 0.841）；对于大量输血，AUC为0.813（95%置信区间，0.759 - 0.866）。验证集上的模型性能，AUC分别为0.739（95%置信区间0.714 - 0.765）、0.730（95%置信区间0.702 - 0.758）和0.713（95%置信区间0.677 - 0.749）。一个完全基于现成电子健康记录的模型能够准确预测术中少量、中度或大量输血情况，并在体外循环心脏手术患者术前提供个性化输血风险概况，且可能有助于指导患者管理。
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