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A precise blood transfusion evaluation model for aortic surgery: a single-center retrospective study

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Abstract

Cardiac aortic surgery is an extremely complicated procedure that often requires large volume blood transfusions during the operation. Currently, it is not possible to accurately estimate the intraoperative blood transfusion volume before surgery. Therefore, in this study, to determine the clinically precise usage of blood for intraoperative blood transfusions during aortic surgery, we established a predictive model based on machine learning algorithms. We performed a retrospective analysis on 4,285 patients who received aortic surgery in Beijing Anzhen Hospital between January 2018 and September 2022. Ultimately, 3,654 patients were included in the study, including 2,557 in the training set and 1,097 in the testing set. By utilizing 13 current mainstream models and a large-scale cardiac aortic surgery dataset, we built a novel machine learning model for accurately predicting intraoperative red blood cell transfusion volume. Based on the transfusion-related risk factors that the model identified, we also established the relevant variables that affected the results. The results revealed that decision tree models were the most suitable for predicting the blood transfusion volume during aortic surgery. In particular, the mean absolute error for the best-performing extremely randomized forest model was 1.17 U, while the R2 value was 0.50. Further exploration into intraoperative blood transfusion during aortic surgery identified erythrocytes, estimated operation duration, body weight, sex, red blood cell count, and D-dimer as the six most significant risk factors. These factors were subsequently analyzed for their influence on intraoperative blood transfusion volume in relevant patients, as well as the protective threshold for prediction. The novel intraoperative blood transfusion prediction model for cardiac aorta surgery in this study effectively assists clinicians in accurately calculating blood transfusion volumes and achieving effective utilization of blood resources. Furthermore, we utilize interpretability technology to reveal the influence of critical risk factors on intraoperative blood transfusion volume, which provides an important reference for physicians to provide timely and effective interventions. It also enables personalized and precise intraoperative blood usage.

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Data availability

The dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Transfusion, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Ji Che, Ying Chang, Jianguo Han & Hui Zhang

  2. Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Bo Yang

  3. Beijing HealSci Technology Co., Ltd, Beijing, China

    Yan Xie & Lei Wang

Authors
  1. Ji Che
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  2. Bo Yang
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  3. Yan Xie
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  4. Lei Wang
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  5. Ying Chang
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  6. Jianguo Han
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  7. Hui Zhang
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Contributions

CJ and YB contributed to study conception and design, acquisition of data, statistical analysis, interpretation of data, drafting the manuscript, and critical revision of the manuscript for important intellectual content. XY, WL, CY, HJ and ZH contributed to acquisition of data, statistical analysis, interpretation of data, and critical revision of the manuscript for important intellectual content. CY, HJ and ZH contributed to interpretation of data and critical revision of the manuscript for important.

Corresponding author

Correspondence to Ji Che.

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The authors declare that they have no competing interests.

Ethical approval

This study protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University.

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This study protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University.

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Che, J., Yang, B., Xie, Y. et al. A precise blood transfusion evaluation model for aortic surgery: a single-center retrospective study. J Clin Monit Comput (2023). https://doi.org/10.1007/s10877-023-01112-3

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  • DOI: https://doi.org/10.1007/s10877-023-01112-3

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