Sánchez-Sotelo VM, Velázquez-Sotelo CE, Guzmán-Delgado NE, Rodríguez-Lacavex M, Díaz-Ortiz B, Martínez-Salazar A

Language: Spanish
References: 10
Page: 13-16
PDF size: 266.45 Kb.

ABSTRACT

Introduction: transfusion leads to complications and mortality in cardiac surgery, with an incidence of 40-90%. There are scales that predict transfusion risk, however, they differ in the number and type of variables; furthermore, few have been compared in Mexican population. Objective: to evaluate the Transfusion Risk Understanding Scoring Tool (TRUST) and Transfusion Risk and Clinical Knowledge (TRACK) scales for risk of transfusion in cardiovascular surgery in the Mexican population. Material and methods: observational, retrospective, comparative study. It included 300 patients older than 18 years who underwent elective cardiovascular surgery. The area under the curve (AUC) of the TRACK and TRUST scores and their relationship with the transfusion variable were evaluated using the ROC curve. The inferential statistics implemented were Student's t and χ². Results: there were 83 women (27.7%) and 217 men (72.3%). 227 Patients (75.7%) were transfused; the majority with hematocrit > 35% (82.2%). Sensitivity, specificity, and AUC to identify high and very high risk patients of the TRACK scale were: 76%, 50% and 0.702, respectively; for the TRUST scale were: 68%, 57% and 0.69, respectively. Conclusions: the TRACK and TRUST scales are useful for transfusion risk stratification in elective cardiac surgery in our population.

REFERENCES

1. Tempe DK, Khurana P. Optimal blood transfusion practice in cardiac surgery. J Cardiothorac Vasc Anesth. 2018;32:2743-2745.

2. Kilic A, Whitman GJR. Blood transfusions in cardiac surgery: indications, risks, and conservation strategies. Ann Thorac Surg. 2014;97:726-734.

3. Vlot EA, Verwijmeren L, van de Garde EMW, Kloppenburg GTL, van Dongen EPA, Noordzij PG. Intra-operative red blood cell transfusion and mortality after cardiac surgery. BMC Anesthesiol [Internet]. 2019;19:65. Available in: https://doi.org/10.1186/s12871-019-0738-2

4. Murphy GJ, Reeves BC, Rogers CA, Rizvi SIA, Culliford L, Angelini GD. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544-2552.

5. Rawn JD. Blood transfusion in cardiac surgery: a silent epidemic revisited. Circulation. 2007;116:2523-2524.

6. Ferraris VA, Ferraris SP, Saha SP, Hessel EA 2nd, Haan CK, Royston BD, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg. 2007;83:S27-S86.

7. Tibi P, McClure RS, Huang J, Baker RA, Fitzgerald D, Mazer CD, et al. STS/SCA/AmSECT/SABM Update to the clinical practice guidelines on patient blood management. Ann Thorac Surg. 2021;112:981-1004.

8. Petricevic M, Petricevic M, Pasalic M, Golubic Cepulic B, Raos M, Vasicek V, et al. Bleeding risk stratification in coronary artery surgery: the should-not-bleed score. J Cardiothorac Surg [Internet]. 2021;16:103. Available in: https://doi.org/10.1186/s13019-021-01473-3

9. Goudie R, Sterne JAC, Verheyden V, Bhabra M, Ranucci M, Murphy GJ. Risk scores to facilitate preoperative prediction of transfusion and large volume blood transfusion associated with adult cardiac surgery ^†. Br J Anaesth. 2015;114:757-766.

10. Leff J, Romano CA, Gilbert S, Nair S. validation study of the transfusion risk and clinical knowledge (TRACK) tool in cardiac surgery patients: a retrospective analysis. J Cardiothorac Vasc Anesth. 2019;33:2669-2675.