The preoperative predictors of transfusion risk in patients after TKA has been explored and preoperative nomogram for predicting transfusion risk has been developed in this study.
Arthroplasty
surgeons often face a dilemma regarding need for a transfusion which one of the
common adverse events after total knee arthroplasty (TKA). As described in this
study, the personalized patient counseling and
decision-making concerning perioperative blood management for total knee arthroplasty (TKA) patients can be improved by using a nomogram based on 5
preoperative predictors.
The
preoperative predictors of transfusion risk in patients after TKA has been
explored and preoperative nomogram for
predicting transfusion risk has been developed in this study.
The training set
of 5402 patients who underwent TKA from September 2013 till November 2018 formed
the basis to make the nomogram. Further, the univariate, LASSO, and binary
logistic regression analyses recognized the independent predictors of
transfusion risk creating a nomogram. It was assessed via area under the curve
(AUC), calibration curve, and decision curve analysis (DCA). The study outcomes
were authenticated by an autonomous set of 1116 patients who undertook TKA from
December 2018 till September 2019. Also, subgroup analyses was done in the
training and testing sets as per these predictors
All in all, 5 predictors were recognized to establish the nomogram. The AUCs of the nomogram were
found to be 0.884 (95% CI: 0.865–0.903) and 0.839 (95% CI, 0.773–0.905) in the
training and testing sets. The calibration curve indicated that the nomogram
predictions were reliable with the actual observation in both the training and
testing sets. The DCA favored the nomogram in terms of clinical effectiveness.
The AUC of the nomogram was appreciably higher as compared to the AUC of any
independent predictor for predicting transfusion risk, and the subgroup
analysis performed well in 20 subgroups.
The independent
predictors of postoperative transfusion in patients following TKA were: lesser
preoperative Hb levels, simultaneous bilateral TKA, lesser BMI, older age, and
coronary heart illness. Hence, a nomogram considering these 5 predictors could precisely
be useful for predicting the transfusion risk.
BMC Musculoskeletal disorders
Development and validation of a nomogram to predict perioperative blood transfusion in patients undergoing total knee arthroplasty
Chuan Hu et al.
Comments (0)