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Updated: May 10, 2026

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Published on: September 30, 2021
Prediction score for effective bleeding control using recombinant activated factor VII in perioperative nonhemophilic
Panthila Rujirojindakul1, Pairaya Rujirojindakul, Edward B McNeil
1Department of Anaesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Background:
Although there has been growing evidence from off-label use of recombinant activated factor VII (rFVIIa) in surgical bleeding, there is limited information on prediction scores.
Methods:
A retrospective study was conducted from 2004 to 2009. The primary outcome was efficacy of bleeding control. Multivariate logistic regression was performed to develop a new prediction score for success of rFVIIa.
Results:
A total of 320 bleeding episodes from 243 nonhemophilic patients who underwent surgery were analyzed. Effective bleeding control was demonstrated in 153 patients. The overall in-hospital mortality rate was 40%. Multivariate analysis identified 4 independent predictors for effective bleeding control: timing of rFVIIa administration, intraoperative blood loss, postoperative international normalization ratio values, and total units of platelets transfused. A rFVIIa success prediction score was developed.
Conclusions:
The use of this new prediction score may support decision making by identifying patients with a high probability of obtaining effective bleeding control from rFVIIa therapy.
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