Single Cancer Center Experience on Patient Blood Management Eligibility in Oncological Surgery

Area of Science:

• Anesthesiology and Perioperative Medicine
• Surgical Oncology
• Transfusion Medicine

Background:

• Optimizing patient blood management (PBM) in oncological surgery requires accurate identification of patients at high risk for perioperative blood transfusion.
• The real-world performance of standard PBM eligibility criteria in this population is not fully understood.

Purpose of the Study:

• To assess transfusion needs in oncological surgery patients.
• To evaluate the effectiveness of two PBM eligibility strategies in identifying patients requiring transfusion and improving anemia management.

Main Methods:

• Retrospective analysis of 4228 oncological surgery and liver transplantation patients.
• Comparison of an observational PBM approach versus a multivariable modeling approach for predicting transfusion risk.
• Evaluation of predictive performance using accuracy, Cramér's V, AUC-ROC, and Brier score.

Main Results:

• Overall transfusion rates were 7.7% (PS24) and 9.2% (PO).
• The observational approach identified 23.8% of patients as PBM-eligible, capturing 87-89% of transfusions.
• Multivariable modeling showed superior individual risk prediction (AUC 0.94-0.95) with predictors including surgical type, anemia, and operative time.

Conclusions:

• Standard PBM criteria effectively identify most patients needing perioperative transfusions in oncological surgery.
• While multivariable modeling offers higher predictive precision, the observational approach provides practical applicability.
• Integrating both strategies can improve transfusion risk stratification and PBM planning.