Transfusion Risk and Clinical Knowledge (TRACK) Score and Cardiac Surgery in Patients Refusing Transfusion

Abstract

Objective: The TransfusionRiskandClinicalKnowledge (TRACK) scoreisasimpletooltopredictthechanceof undergoingbloodtransfusionincardiacsurgery.The authors evaluatedtherelationshipbetweentheTRACK score andclinicaloutcomesofcardiacsurgeryinpatients who refusedbloodtransfusion. Design: An observationalstudy. Setting: A singlehospital. Participants: Seventy-sixadultJehovah’s Witnessesrefus- ingbloodtransfusionwhounderwentcardiacsurgeries. Interventions: Patientsweredividedinto2groups accordingtotheirTRACKscore:low-riskgroup(n ¼ 57, TRACK scoreoflessthan13)andhigh-riskgroup(n ¼ 19, TRACKscoreof13ormore).Perioperativeandlong- term clinicaloutcomeswerecomparedbetweenthe2 groups. MeasurementsandMainResults: The operativemortality was 0%inthelow-riskgroup,and21.1%(n ¼ 4) inthehigh- risk group(p ¼ 0.003). Theincidenceofmajorpostoperative complicationswashigherinthehigh-riskgroup(57.9%)thanin the low-riskgroup(17.5%)(p ¼ 0.002).Thehigh-riskgrouphad more postoperativebleeding-relatedcomplications(21.1%) than didthelow-riskgroup(1.8%)(p ¼ 0.013). Therewere no significant differencesofpredictive performanceinmortal- ity andmorbiditybetweentheTRACKscoreandEuroSCOREII. Conclusion: In cardiacsurgerypatientsrefusingtransfu- sions, theTRACKscorepredictedpostoperativemorbidity and mortalityofcardiacsurgery.