Preoperative predictors of the need for allogeneic blood transfusion in lung cancer surgery

BACKGROUND: The use of blood-saving techniques in elective surgery can prod uce a favorable cost-benefit ratio only when there is a reasonable likeliho od that transfusion will be required. To apply a targeted blood-sparing tec hnique in lung cancer surgery, the patient's preoperative characteristics t hat predict: the use of allogeneic blood transfusion (ABT) in this practice were investigated. STUDY DESIGN AND METHODS: One hundred seventy-three consecutive patients wh o underwent primary lung cancer surgery were included in this retrospective study. Clinical and epidemiologic variables, lung tumor extension (TNM sta ging), and surgery type were analyzed by logistic regression to discover th e preoperative predictors of ABT. RESULTS: Thirty patients, 17.3 percent of all who underwent surgery and 19. 9 percent of those who underwent resolvent surgery, received ABT. Excluding a patient who needed 18 units of RBCs, the number of ABI units required by transfused patients was 1.93 +/- 0.88 (mean +/- SD). Extensive surgery, pa tient's age (less than or equal to 64 years), and elevated erythrocyte sedi mentation rate (>45 mm/hour) were the preoperative variables that influence d the need for ABT. The definitive predictive model was able to recognize 8 2.3 percent of patients who received ABT and 95.6 percent of those who did not. CONCLUSION: A predictive model can preoperatively identify patients at risk for needing ABT in lung cancer surgery. The model could be utilized to tai lor blood-sparing intervention programs.