KEY TAKEAWAYS
- The study aimed to investigate a pre-operative tool to estimate the risk of peri-operative blood transfusion in pts with OC surgery.
- The BLOODS score effectively identifies pts with OC who would benefit from enhanced surgical planning and blood-saving techniques.
Ryan M Kahn and the team aimed to develop a pre-operative tool to estimate the risk of peri-operative packed red blood cell transfusion in primary debulking surgery for patients (pts) with ovarian cancer (OC).
Researchers performed an inclusive analysis by retrospectively reviewing an institutional database to identify pts who underwent primary debulking surgery for OC at a single center between January 1, 2001, and May 31, 2019. They calculated the receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) to evaluate the model’s performance. Five-fold cross-validation was applied to the multivariate model to ensure robustness.
Significant variables were assigned a BLOODS (BLood transfusion Over an OC Debulking Surgery) score of +1 if present. A total BLOODS score was calculated for each patient, and the odds of receiving a transfusion were determined for each score.
About 1566 pts met eligibility criteria; 800 (51%) underwent a peri-operative blood transfusion. Odds ratios (OR) were statistically significant for American Society of Anesthesiologists scores of 3 and 4 (OR 1.34, 95% CI) 1.09 to 1.63), pre-operative levels of cancer antigen 125 (CA125) (OR 2.43, 95% CI 1.98 to 2.99), platelets (OR 1.59, 95% CI 1.45 to 1.74), obesity (OR 0.76, 95% CI 0.60 to 0.96), presence of carcinomatosis (OR 2.45, 95% CI 1.93 to 3.11), bulky upper abdominal disease (OR 2.86, 95% CI 2.32 to 3.54), pre-operative serum albumin level (OR 0.31, 95% CI 0.24 to 0.40), and pre-operative hemoglobin level (OR 0.56, 95% CI 0.51 to 0.61). The corrected AUC was 0.748 (95% CI 0.693 to 0.804). BLOODS scores of 0 and 5 corresponded to 11% and 73% odds, respectively, of receiving a peri-operative blood transfusion.
The study concluded that the BLOODS score is a universal pre-operative scoring system that helps identify pts with OC who would benefit from surgical planning and blood-saving techniques. The score is directly proportional to the American Society of Anesthesiologists score, presence of upper abdominal disease, carcinomatosis, CA125 level, and platelets level. This model can assist physicians with surgical planning and improve patient outcomes.
This research was funded by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748.
Source: https://pubmed.ncbi.nlm.nih.gov/38950927/
Kahn RM, Boerner T, Kim M, et al. (2024). “A pre-operative scoring model to estimate the risk of blood transfusion over an ovarian cancer debulking surgery (BLOODS score): a Memorial Sloan Kettering Cancer Center Team Ovary study.” Int J Gynecol Cancer. 2024 Jul 1;34(7):1051-1059. doi: 10.1136/ijgc-2024-005660. PMID: 38950927.
