Comparison of scoring systems for bleeding in open cardiac surgery patients.

BACKGROUND/AIM: The aim of our study was to determine which preoperative bleeding risk scoring system is more sensitive in predicting perioperative transfusion requirement in patients undergoing open-heart surgery.

MATERIALS AND METHODS

This is a retrospective single-center cohort study. Seven scoring systems (TRACK, PAPWORTH, WILL-BLEED, CRUSADE, ACTION, TRUST, ACTA-PORT) were used to predict the likelihood of perioperative erythrocyte suspension (ES) transfusion requirement.

RESULTS

Four hundred patients were enrolled in the study. Age, creatinine level, and diagnoses of diabetes mellitus and hypertension were significantly higher in patients who required ES (p < 0.05). In addition, ejection fraction percentages and hemoglobin and hematocrit levels were significantly lower (p < 0.05). Except for PAPWORTH; ACTION, ACTA-PORT, WILL-BLEED, TRACK, TRUST, and CRUSADE scores were higher in the ES group (p < 0.05), but the most predictive scoring system for ES use was TRUST.

CONCLUSION

The ACTION and ACTA-PORT systems were also found to significantly predict ES use, but the WILL-BLEED, TRUST, and TRACK systems were found to be more predictive of bleeding and ES transfusion requirement in CABG operations. Furthermore, low EF, Hb, and Hct levels, higher creatinine levels, and the presence of DM were identified as individual risk factors for perioperative bleeding, apart from the scoring systems.