Development and validation of a predictive score for perioperative transfusion in patients with hepatocellular carcinoma undergoing liver resection  

作　　者：Hai-Qing Wang Jian Yang Jia-Yin Yang Wen-Tao Wang Lu-Nan Yan 

机构地区：[1]Department of Liver Surgery, West China Hospital, Sichuan University

出　　处：《Hepatobiliary & Pancreatic Diseases International》2015年第4期394-400,共7页国际肝胆胰疾病杂志（英文版）

基　　金：supported by grants from the National Science and Technology Major Project of China(2012ZX10002-016 and 2012ZX10002-017)

摘　　要：Liver resection is a major surgery requiring perioperative blood transfusion. Predicting the need for blood transfusion for patients undergoing liver resection is of great importance. The present study aimed to develop and validate a model for predicting transfusion requirement in HBV-related hepatocellular carcinoma patients undergoing liver resection. METHODS： A total of 1543 consecutive liver resections were included in the study. Randomly selected sample set of 1080 cases （70% of the study cohort） were used to develop a predic- tive score for transfusion requirement and the remaining 30% （n=463） was used to validate the score. Based on the preopera- tive and predictable intraoperative parameters, logistic regres- sion was used to identify risk factors and to create an integer score for the prediction of transfusion requirement. RESULTS： Extrahepatic procedure, major liver resection, hemoglobin level and platelets count were identified as inde- pendent predictors for transfusion requirement by logistic regression analysis. A score system integrating these 4 factors was stratified into three groups which could predict the risk of transfusion, with a rate of 11.4%, 24.7% and 57.4% for low, moderate and high risk, respectively. The prediction model appeared accurate with good discriminatory abilities, generat- ing an area under the receiver operating characteristic curve of 0.736 in the development set and 0.709 in the validation set. CONCLUSIONS： We have developed and validated an integer- based risk score to predict perioperative transfusion for pa- tients undergoing liver resection in a high-volume surgicalcenter. This score allows identifying patients at a high risk and may alter transfusion practices.Liver resection is a major surgery requiring perioperative blood transfusion. Predicting the need for blood transfusion for patients undergoing liver resection is of great importance. The present study aimed to develop and validate a model for predicting transfusion requirement in HBV-related hepatocellular carcinoma patients undergoing liver resection. METHODS： A total of 1543 consecutive liver resections were included in the study. Randomly selected sample set of 1080 cases （70% of the study cohort） were used to develop a predic- tive score for transfusion requirement and the remaining 30% （n=463） was used to validate the score. Based on the preopera- tive and predictable intraoperative parameters, logistic regres- sion was used to identify risk factors and to create an integer score for the prediction of transfusion requirement. RESULTS： Extrahepatic procedure, major liver resection, hemoglobin level and platelets count were identified as inde- pendent predictors for transfusion requirement by logistic regression analysis. A score system integrating these 4 factors was stratified into three groups which could predict the risk of transfusion, with a rate of 11.4%, 24.7% and 57.4% for low, moderate and high risk, respectively. The prediction model appeared accurate with good discriminatory abilities, generat- ing an area under the receiver operating characteristic curve of 0.736 in the development set and 0.709 in the validation set. CONCLUSIONS： We have developed and validated an integer- based risk score to predict perioperative transfusion for pa- tients undergoing liver resection in a high-volume surgicalcenter. This score allows identifying patients at a high risk and may alter transfusion practices.

关 键 词：liver resection TRANSFUSION hepatocellular carcinoma 

分 类 号：R735.7[医药卫生—肿瘤]