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

作者：Junqi Su, Shang Xie, Zhigang Cai, Xiaoying Wang · 发表于：Annals of Translational Medicine · 年份：2021 · DOI：10.21037/atm-21-1484 · 被引用次数：6 · 研究领域：Blood transfusion and management、Head and Neck Cancer Studies、Reconstructive Surgery and Microvascular Techniques

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...