Developing a predictive risk score for perioperative blood transfusion: a retrospective study in patients with oral and oropharyngeal squamous cell carcinoma undergoing free flap reconstruction surgery.
Developing a predictive risk score for perioperative blood transfusion: a retrospective study in patients with oral and oropharyngeal squamous cell carcinoma undergoing free flap reconstruction surgery.
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制定围手术期输血的预测风险评分：接受游离皮瓣重建手术的口腔和口咽鳞状细胞癌患者的回顾性研究
DOI：
10.21037/atm-21-1484
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发表时间：
2021-05
影响因子：
--
通讯作者：
Wang XY
中科院分区：
文献类型：
--
作者：
Su JQ;Xie S;Cai ZG;Wang XY
背景目前尚缺乏一种简单准确的评分系统来预测口腔及口咽鳞状细胞癌（OOSCC）行肿瘤切除即刻游离皮瓣重建原发性手术患者输血风险。预测口腔癌患者的输血需求具有重要的临床意义。本研究旨在提出一个有效的模型来预测OOSCC游离皮瓣重建手术患者的输血需求。方法回顾性研究2012年至2019年385例局部晚期OOSCC行肿瘤手术即刻游离皮瓣重建的患者。测量的主要结果是患者接受围手术期异体输血的暴露情况。基于独立风险变量及其比值比的多变量模型，建立输血风险评分（TRS）来预测围手术期输血的可能性。采用受试者工作特征曲线下面积（ROC）评价模型的判别精度，采用约登指数（Youden index）确定最佳分割点。结果Logistic回归分析发现，淋巴结状态、术前血红蛋白（Hb）水平、骨切除、骨游离组织转移和手术时间是输血的独立预测因素。综合这些变量的TRS分为三类。TRS对输血风险的预测能力较好，总体ROC曲线下面积（AUC）为0.826。在最佳临界值为5.5时，TRS的敏感性为72.3%，特异性为78.2%。ROC分析显示，TRS≥5.5的患者围手术期输血的需求更大。结论使用基于整数的TRS可以识别可能需要围手术期输血的OOSCC肿瘤切除术患者。
Background A simple and accurate scoring system to predict risk of blood transfusion in patients having surgical tumor resection with immediate free flap reconstruction primary surgery for oral and oropharyngeal squamous cell carcinoma (OOSCC) is lacking. Anticipating the blood transfusion requirements in patients with oral cancer is of great clinical importance. This research aimed to propose a valid model to predict transfusion requirements in patients undergoing surgery with free flap reconstruction for an OOSCC. Methods This retrospective study consisted of 385 patients who underwent oncologic surgery with immediate free flap reconstruction for locally advanced OOSCC from 2012 to 2019. The primary outcome measured was the exposure of patients to perioperative allogeneic blood transfusion. Based on a multivariate model of independent risk variables and their odds ratio, a blood transfusion risk score (TRS) was developed to predict the likelihood of the perioperative blood transfusion. The discriminatory accuracy of the model was evaluated using the area under the receiver operating characteristic (ROC) curve, and Youden index was used to identify the optimal cut-point. Results Logistic regression analyses identified lymph node status, preoperative hemoglobin (Hb) levels, bone resection, osseous free tissue transfer, and operative duration were identified as independent predictors of blood transfusion. A TRS integrating these variables was separated into three categories. The TRS assessed the transfusion risk with good predictive ability, with an overall area under the ROC curve (AUC) was 0.826. At the optimal cut-point of 5.5, the TRS had a sensitivity of 72.3% and a specificity of 78.2%. The ROC analysis showed that patients with a TRS of 5.5 or more had a greater requirement for perioperative transfusion. Conclusions The use of the integer-based TRS allowed the identification of high-risk patients who may require perioperative transfusion undergoing tumor resection surgery for the treatment of OOSCC.
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影响因子：
1.8
作者：
Salma, Ra'ed Ghaleb;Al-Shammari, Fahad Mohammed;Al-Qarzaee, Mohammed Abdullah
通讯作者：
Al-Qarzaee, Mohammed Abdullah
DOI：
10.1016/j.ijom.2015.11.008
发表时间：
2016-04-01
影响因子：
2.4
作者：
Oh, A. Y.;Seo, K. S.;Kim, H. J.
通讯作者：
Kim, H. J.
影响因子：
1.9
作者：
Nath, A;Pogrel, MA
通讯作者：
Pogrel, MA
影响因子：
2.9
作者：
Singbartl, Guenter;Held, Anna-Lena;Singbartl, Kai
通讯作者：
Singbartl, Kai
影响因子：
3.1
作者：
Loeffelbein, Denys J.;Julinek, Annette;Haseneder, Rainer
通讯作者：
Haseneder, Rainer