Preoperative Hemoglobin and Actual Need for Blood Transfusion in Brain Tumor Resection Procedures: A Retrospective Cohort Study

Tomás-Biosca, Ana; Martínez-Simón, Antonio; Guridi, Jorge; Solís, Sonia Tejada; Bejarano, Bartolomé; Honorato‐Cia, Cristina; Cacho‐Asenjo, Elena; Núñez‐Córdoba, Jorge M.

doi:10.1097/ana.0000000000000753

Cited by 2 publications

(4 citation statements)

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“…We examined readily available preoperative risk factors for blood transfusion in brain tumor surgery patients and, among these, preoperative hemoglobin level, previous craniotomy at the site of resection, number of planned craniotomy sites and brain tumor volume were selected to build a simplified predictive model for RBC requirements. We confirmed the inverse association between preoperative hemoglobin level and perioperative transfusion in brain tumor surgery, as previously reported 15. Low preoperative hemoglobin has been associated with blood transfusion in both adults and children 26,35…”

Section: Discussionsupporting

confidence: 90%

“…We confirmed the inverse association between preoperative hemoglobin level and perioperative transfusion in brain tumor surgery, as previously reported. 15 Low preoperative hemoglobin has been associated with blood transfusion in both adults and children. 26,35 We also identified brain tumor volume as a potential predictor of RBC transfusion.…”

Section: Discussionmentioning

confidence: 99%

“…In an effort to increase efficiency of blood management during surgical interventions, blood order schedules and guidelines for common elective procedures have been developed 1,6–8. However, objective risk factors associated with RBC transfusion requirements in patients undergoing craniotomy for brain tumor resection have been sparsely studied 9–17…”

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confidence: 99%

“…1,[6][7][8] However, objective risk factors associated with RBC transfusion requirements in patients undergoing craniotomy for brain tumor resection have been sparsely studied. [9][10][11][12][13][14][15][16][17] Neurosurgical patients may be particularly intolerant to anemia because of its contribution to secondary cerebral injury. 18,19 Although the optimal hemoglobin concentration for neurologically injured patients appears to be in the range of 9 to 10 g/dL, 20 transfusion thresholds in brain tumor surgery remain undefined.…”

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Development and Performance Evaluation of a Clinical Predictive Model to Estimate the Risk of Red Blood Cell Requirements in Brain Tumor Surgery

Tomás-Biosca¹,

Martínez-Simón

Guridi³

et al. 2021

Journal of Neurosurgical Anesthesiology

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Background:The identification of factors associated with perioperative red blood cell (RBC) transfusion provides an opportunity to optimize the patient and surgical plan, and to guide perioperative crossmatch and RBC orders. We examined the association among potential bleeding risk factors and RBC requirements to develop a novel predictive model for RBC transfusion in patients undergoing brain tumor surgery.Methods: This retrospective study included 696 adults who underwent brain tumor surgery between 2008 and 2018. Multivariable logistic regression with backward stepwise selection for predictor selection was used during modeling. Model performance was evaluated using area under the receiver operating characteristic curve, and calibration was evaluated with Hosmer-Lemeshow goodness-of-fit χ 2 -estimate.Results: Preoperative hemoglobin level was inversely associated with the probability of RBC transfusion (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.39-0.63; P < 0.001). The need for RBC transfusion was also greater in patients who had a previous craniotomy (OR: 2.71; 95% CI: 1.32-5.57; P = 0.007) and in those with larger brain tumor volume (OR: 1.01; 95% CI: 1.00-1.02; P = 0.009). The relationship between number of planned craniotomy sites and RBC transfusion was not statistically significant (OR: 2.11; 95% CI: 0.61-7.32; P = 0.238). A predictive model for RBC requirements was built using these 4 variables. The area under the receiver operating characteristic curve was 0.79 (95% CI: 0.70-0.87; P < 0.001) showing acceptable calibration for predicting RBC transfusion requirements.Conclusions: RBC requirements in patients undergoing brain tumor surgery can be estimated with acceptable accuracy using a predictive model based on readily available preoperative clinical variables. This predictive model could help to optimize both individual patients and surgical plans, and to guide perioperative crossmatch orders.

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confidence: 90%