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

• Published in: Journal of cardiothoracic and vascular anesthesia 2016-04, Vol.30 (2), p.373-378
• Main Authors: Kim, Tae Sik, MD, Lee, Jong Hyun, MD, An, Hyonggin, PhD, Na, Chan-Young, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia & Perioperative Care; blood transfusion; Blood Transfusion - mortality; cardiac surgery; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; cardiopulmonary bypass; Critical Care; Female; Health Knowledge, Attitudes, Practice; Humans; Jehovah's Witnesses; Male; Middle Aged; perioperative care; Perioperative Period; Postoperative Complications - epidemiology; Predictive Value of Tests; Retrospective Studies; Risk; Transfusion Reaction; Treatment Outcome; Treatment Refusal
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2015.11.004

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.