Influencing Factors of Red Blood Cell Transfusion Efficiency in Surgical Patients
Objective To explore the factors affecting the effective rate of red blood cell transfusion in surgical patients,and to provide reference for improving the effective rate of red blood cell transfusion in clinic.Methods A total of 162 surgical patients who received red blood cell transfusion in Zhumadian Central Hospital from January 2020 to December 2022 were selected.The effective rate of red blood cell transfusion was calculated,clinical data were collected,and the influencing factors of red blood cell transfusion efficiency in surgical patients were analyzed by Lasso-logistic regression.Results Among 162 surgical patients who received red blood cell transfusion,130 cases(80.25％)were effective and 32 cases(19.75％)were ineffective.The proportion of ineffective patients who were female,had a history of previous blood transfusions,autoimmune diseases,malignant tumors,infections,hepatosplenomegaly,and anemia was higher than that of effective patients(P＜0.05).Invalid patients had higher red blood cell retention days,pre transfusion white blood cell count,and neutrophil percentage than effective patients,while ineffective patients had lower hemoglobin and hematocrit before transfusion than effective patients(P＜0.05).The proportion of plasma and red blood cells in ineffective patients was significantly different from that in effective patients(P＜0.05).Lasso regression analysis identified 10 factors:history of previous blood transfusions,history of autoimmune diseases,history of malignant tumors,infection,anemia history,red blood cell preservation days,plasma to red blood cell ratio,pre transfusion hemoglobin,hematocrit,and white blood cell count.Logistic regression analysis showed that all 10 factors were independent influencing factors on the effectiveness of red blood cell transfusion in surgical patients(P＜0.05).Based on this,a prediction model for the effectiveness of red blood cell transfusion in surgical patients was constructed.The calibration curve showed that the calibration degree of the prediction model was 0.827,and the consistency index was 0.809.The ROC curve showed that the AUC of the prediction model for the effectiveness of red blood cell transfusion in surgical patients was 0.918.Conclusion Constructing a predictive model for the effectiveness of red blood cell transfusion in surgical patients based on factors such as past transfusion history,autoimmune disease history,malignant tumor history,infection,anemia history,red blood cell preservation days,plasma to red blood cell ratio,pre transfusion hemoglobin,hematocrit,white blood cell count,etc.has reliable predictive value and can provide guidance information for clinical practice.
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