Preoperative prediction of intra and postoperative red blood cell transfusion in surgical patients

Anaesthetists were asked to predict the need for intra and postoperative red blood cell transfusion in 1706 patients before surgery. Each prediction was made using only the individual patient's medical history and physical examination, the results of routine preoperative laboratory investigations, and knowledge of the proposed surgical procedure. Only 159 patients (9.3%) received red blood cell transfusion. The sensitivity and specificity of this preoperative prediction were 85.5% and 96.6% respectively, whereas the positive and negative predictive values were 72.3% and 98.5% respectively. Using a stepwise logistic regression model, preoperative haemoglobin concentration, Surgical Table of the procedure, and age of patients were found to significantly determine the need for intra and postoperative red blood cell transfusion. It is recommended that type and screen should replace group and crossmatch procedures in surgical patients where no intra and postoperative red blood cell transfusion is predicted as necessary.