Alghamdi et al developed the Transfusion Risk Understanding
Scoring Tool (TRUST) for identifying cardiac surgery patients who may need
blood transfusion. This can help identify patients who may be candidates for
preventive measures to reduce the need for transfusion. The authors are from
the Univiersity of Toronto.
|
Parameter
|
Finding
|
Points
|
|
age of the patient in years
|
<= 65 years
|
0
|
|
|
> 65 years
|
1
|
|
gender
|
male
|
0
|
|
|
female
|
1
|
|
hemoglobin
|
>= 13.5 g/dL
|
0
|
|
|
< 13.5 g/dL
|
1
|
|
body weight in kilograms
|
>=77 kilograms
|
0
|
|
|
< 77 grams
|
1
|
|
elective surgery
|
yes
|
0
|
|
|
no (nonelective)
|
1
|
|
serum creatinine
|
<= 1.36 mg/dL (120 µmol/L)
|
0
|
|
|
> 1.36 mg/dL (120 µmol/L)
|
1
|
|
history of prevous cardiac surgery
|
no
|
0
|
|
|
yes
|
1
|
|
surgical task
|
isolated
|
0
|
|
|
nonisolated (CABG + valve replacement, etc
|
1
|
• The higher the score the greater the probability of
requiring a blood transfusion.
|
Total Score
|
Risk Group
|
Probability of Transfusion
|
|
0
|
baseline risk
|
< 20%
|
|
1
|
low risk
|
20 - 39%
|
|
2
|
intermediate risk
|
40 - 59%
|
|
3
|
high risk
|
60 - 79%
|
|
4 to 8
|
very high risk
|
80 - 100%
|