Independent Validation of a Model Predicting the Need for Packed Red Blood Cell Transfusion at Liver Transplantation
Independent Validation of a Model Predicting the Need for Packed Red Blood Cell Transfusion at Liver Transplantation
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DOI：
10.1097/tp.0b013e3181aed477
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发表时间：
2009-08-15
期刊：
影响因子：
6.2
通讯作者：
Karakiewicz, Pierre I.
中科院分区：
文献类型：
--
作者：
Massicotte, Luc;Capitanio, Umberto;Karakiewicz, Pierre I.
目标.原位肝移植（奥尔特）可能与大量失血和同样大量的输血需求有关。我们以前已经开发了一个模型，能够预测的概率包装红细胞（PRBC）输血。我们测试了该模型在转换为诺模图格式后预测PRBC输血需求的能力，诺模图格式是一种友好的工具。此外，诺模图验证了一个独立的队列109前瞻性收集的OLT。材料与方法。由17名麻醉师和7名肝胆外科医生组成的小组共进行了515例OLT。最初的406个OLT系列用于模型开发。其余109例OLT用作独立验证队列。Logistic回归分析探讨了先前确定的PRBC输血可能性的三个预测因子与PRBC输血的实际发生率之间的关系。预测因子包括血浆输注状态、静脉切开术和术前即刻血红蛋白值。采用多变量Logistic回归模型，将所有3个预测因子的回归系数用于绘制预测PRBC输注个体概率的列线图。在单变量模型中，输血浆（比值比[OR] 15.0，P
Objectives. Orthotopic liver transplantation (OLT) may be associated with major blood loss and equally considerable transfusion requirements. We had developed previously a model capable of predicting the probability of packed red blood cell (PRBC) transfusion. We tested the ability of that model in predicting the need for PRBC transfusion after its conversion into the nomogram format, which represents a friendly tool to be used. Moreover, the nomogram was validated in an independent cohort of 109 prospectively gathered OLTs.Materials and Methods. A total of 515 OLTs were performed by a group of 17 anesthesiologists and 7 hepatobiliary surgeons. The initial series of 406 OLTs were used for model development. The remaining 109 OLTs were used as an independent validation cohort. Logistic regression analyses addressed the relationship between the three previously identified predictors of the likelihood of PRBC transfusion and the actual rate of PRBC transfusion. The predictors consisted of plasma transfusion status, phlebotomy, and immediate preoperative hemoglobin value. The regression coefficients from the multivariable logistic regression model that included all three predictors were used to develop a nomogram predicting the individual probability of PRBC transfusion.Results. In univariable models, transfusion of plasma (odds ratio [OR] 15.0, P