Welsby et al developed a clinical prediction tool for estimating the number of untis of red blood cells needed for a patient undergoing primary elective coronary artery bypass surgery. This can help to conserve blood products while maintaining patient safety. The authors are from Duke University in Durham, North Carolina.
Parameters:
(1) body weight in kilograms
(2) left ventricular ejection fraction (LVEF) in percent
(3) serum creatinine in mg/dL
(4) gender
(5) preoperative hematocrit in percent
(6) age in years
|
Parameter |
Finding |
Points |
|
body weight in kilograms |
>= 85 kg |
0 |
|
|
55 to 84.9 kg |
0.5 |
|
|
< 55 kg |
1.5 |
|
LVEF |
>= 30% |
0 |
|
|
< 30% |
0.5 |
|
serum creatinine |
<= 1.2 mg/dL |
0 |
|
|
1.2 to 1.4 mg/kg |
0.5 |
|
|
> 1.4 mg/kg |
1.5 |
|
gender |
male |
0 |
|
|
female |
1 |
|
hematocrit |
>= 36% |
0 |
|
|
< 36% |
1 |
|
age |
<= 60 years |
0 |
|
|
60.1 to 85 years |
1 |
|
|
> 85 years |
1.5 |
where:
• The data in Table 4 is ambiguous. An alternative interpretation might be to combine values if more than one is matched (for example a body weight of < 55 kg could be scored as 2 points since it is < 85 and < 55).
• Primary indicates first time surgery and not a "redo".
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The score is the number of units of packed RBCs predicted.
Specialty: Clinical Laboratory, Surgery, general, Anesthesiology, Emergency Medicine, Critical Care
