A model based on electronic health records to predict transfusion events in on-pump cardiac surgery
Dong Xu Chen,
Yi Shun Wang,
Min Yan,
Lei Du,
Qian Li
Affiliations
Dong Xu Chen
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
Yi Shun Wang
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
Min Yan
Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 330100, P.R.China
Lei Du
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; Corresponding author
Qian Li
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; Corresponding author
Summary: 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.
