Arthroplasty Blood Transfusion - Total Joint Arthroplasty Rule

Description

Rashiq et al developed a score for predicting the need for blood transfusion for a patient undergoing a total joint arthroplasty. These factors are known prior to surgery and can identify who may require more aggressive blood conservation. The authors are from the University of Alberta in Canada.

Patient selection: hip or knee joint replacement surgery

Preoperative parameters:

(1) age in years

(2) gender

(3) body weight in kilograms

(4) hemoglobin in g/dL

(5) ASA classification

(6) revision surgery

Parameter	Finding	Points
age in years	< 65 years of age	0
	65 to 79 years of age	20
	>= 80 years of age	30
gender	male	0
	female	20
body weight	<= 60 kilograms	65
	61 to 70 kg	40
	71 to 80 kg	25
	81 to 90 kg	20
	> 90 kg	0
hemoglobin	<= 120 g/L	140
	121 to 130 g/L	95
	131 to 140 g/L	40
	141 to 150 g/L	35
	> 150 g/L	0
ASA classification	I or II	0
	III, IV or V	15
revision surgery	no	0
	yes	25

where:

• There probably are not many total joint replacements in someone with ASA Class IV or V.

• Some people would use different cutoffs for hemoglobin based on gender.

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 295

• The higher the score the greater the likelihood of allogeneic blood transfusion.

Total Score	Probability
<= 100	<= 10%
101 to 150	10 to 30%
151 to 200	30 to 50%
201 to 295	> 50%

Performance:

• The area under the ROC curve is 0.80.

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Description

Specialty

Objective

ICD-10

Clinical Prediction Rule of Rashiq et al for Allogeneic Blood Transfusion to a Patient Undergoing Total Joint Arthroplasty

Purpose: To identify the need for blood transfusion for a patient undergoing total joint replacement based on the prediction rule of Rashiq et al.

Description

Specialty

Objective

ICD-10