Tae Sik Kim1, Jong Hyun Lee2, Hyonggin An3, Chan-Young Na4. 1. Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea;. Electronic address: kmdphd@gmail.com. 2. †Department of Anesthesiology, Sejong General Hospital, Bucheon, Republic of Korea; 3. ‡Department of Biostatistics, Korea University Medical Center, Seoul, Republic of Korea. 4. §Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
Abstract
OBJECTIVE: The Transfusion Risk and Clinical Knowledge (TRACK) score is a simple tool to predict the chance of undergoing blood transfusion in cardiac surgery. The authors evaluated the relationship between the TRACK score and clinical outcomes of cardiac surgery in patients who refused blood transfusion. DESIGN: An observational study. SETTING: A single hospital. PARTICIPANTS: Seventy-six adult Jehovah's Witnesses refusing blood transfusion who underwent cardiac surgeries. INTERVENTIONS: Patients were divided into 2 groups according to their TRACK score: low-risk group (n = 57, TRACK score of less than 13) and high-risk group (n = 19, TRACK score of 13 or more). Perioperative and long-term clinical outcomes were compared between the 2 groups. MEASUREMENTS AND MAIN RESULTS: The operative mortality was 0% in the low-risk group, and 21.1% (n = 4) in the high-risk group (p = 0.003). The incidence of major postoperative complications was higher in the high-risk group (57.9%) than in the low-risk group (17.5%) (p = 0.002). The high-risk group had more postoperative bleeding-related complications (21.1%) than did the low-risk group (1.8%) (p = 0.013). There were no significant differences of predictive performance in mortality and morbidity between the TRACK score and EuroSCORE II. CONCLUSION: In cardiac surgery patients refusing transfusions, the TRACK score predicted postoperative morbidity and mortality of cardiac surgery.
OBJECTIVE: The Transfusion Risk and Clinical Knowledge (TRACK) score is a simple tool to predict the chance of undergoing blood transfusion in cardiac surgery. The authors evaluated the relationship between the TRACK score and clinical outcomes of cardiac surgery in patients who refused blood transfusion. DESIGN: An observational study. SETTING: A single hospital. PARTICIPANTS: Seventy-six adult Jehovah's Witnesses refusing blood transfusion who underwent cardiac surgeries. INTERVENTIONS:Patients were divided into 2 groups according to their TRACK score: low-risk group (n = 57, TRACK score of less than 13) and high-risk group (n = 19, TRACK score of 13 or more). Perioperative and long-term clinical outcomes were compared between the 2 groups. MEASUREMENTS AND MAIN RESULTS: The operative mortality was 0% in the low-risk group, and 21.1% (n = 4) in the high-risk group (p = 0.003). The incidence of major postoperative complications was higher in the high-risk group (57.9%) than in the low-risk group (17.5%) (p = 0.002). The high-risk group had more postoperative bleeding-related complications (21.1%) than did the low-risk group (1.8%) (p = 0.013). There were no significant differences of predictive performance in mortality and morbidity between the TRACK score and EuroSCORE II. CONCLUSION: In cardiac surgery patients refusing transfusions, the TRACK score predicted postoperative morbidity and mortality of cardiac surgery.
Authors: N R Madhu Krishna; P S Nagaraja; Naveen G Singh; S N Nanjappa; Karthik Narendra Kumar; V Prabhakar; N Manjunatha Journal: Ann Card Anaesth Date: 2019 Jan-Mar