Perioperative medicine & outcomes
Development and Validation of a Risk Model to Predict Intraoperative Blood Transfusion
Authors' conclusion
In this prognostic study of surgical patients, the Transfusion Forecast Utility for Surgical Events (TRANSFUSE) model for predicting intraoperative pRBC transfusion was developed and validated.
Study context
- Population
- Patients aged 18 years or older undergoing surgery at MMC (Bronx, New York) and BIDMC (Boston, Massachusetts)273,654 MMC
- Participants
- 816,618 patients
- Comparison
- Transfusion Forecast Utility for Surgical Events (TRANSFUSE) model vs Transfusion Risk Understanding Scoring Tool
- Outcome
- Intraoperative transfusion of 1 or more pRBC units
Methodological detailsdevelopment and validation of a risk prediction model, registry data, 2 quaternary hospital networks, internal and external validation, stepwise backward regression
- Development and validation of a risk prediction model
- Registry data
- 2 quaternary hospital networks
- Internal and external validation
- Stepwise backward regression
Performance
As reported in the abstract
Prediction of intraoperative pRBC transfusion (model performance)
- AUC of final model
- 0.93 (95% CI, 0.92-0.93)
- PPV of final model
- 8.9% (95% CI, 8.7%-9.2%)
- NPV of final model
- 99.7% (95% CI, 99.7%-99.7%)
- Model outperformed the Transfusion Risk Understanding Scoring Tool: AUC 0.64 [0.63-0.64]; PPV 2.6% [95% CI, 2.5%-2.6%]; NPV 99.2% [95% CI, 99.1%-99.3%]
- P < .001
Further findings
Incidence of intraoperative packed red blood cells (pRBC) transfusion (≥1 unit)
- Patients receiving at least 1 unit of pRBC
- 18 662 (2.3%)
Original publication
Development and Validation of a Risk Model to Predict Intraoperative Blood Transfusion. JAMA Netw Open. Published 1 April 2025. doi:10.
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