The usefulness of a classification and regression tree algorithm for detecting perioperative transfusion-related pulmonary complications.
Background: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are leading causes of transfusion-related mortality. An electronic medical record-based screening classification and regression tree (CART) algorithm was previously developed for predicti...
| Publicado en: | Transfusion Vol. 55; no. 11; pp. 2582 - 2590 |
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| Autores principales: | , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110860185&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110860185 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00411132 1YB jtl: Transfusion issn: 00411132 maglogo: Y pubinfo: dt: Nov2015 vid: 55 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 110860185 110860185 NLM26095216 110860185 10.1111/trf.13202 NLM26095216 110860185 ppf: 2582 ppct: 8 formats: tig: atl: The usefulness of a classification and regression tree algorithm for detecting perioperative transfusion-related pulmonary complications. aug: au: Kim, Kyu Nam Kim, Dong Won Jeong, Mi Ae affil: Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul Republic of Korea sug: subj: Blood Transfusion Reaction Diagnosis Acute Lung Injury Etiology Algorithms Male Intraoperative Period Adult Middle Age Aged Retrospective Design Female Human Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are leading causes of transfusion-related mortality. An electronic medical record-based screening classification and regression tree (CART) algorithm was previously developed for predicting transfusion-related pulmonary complications. In the Republic of Korea, TRALI is not sufficiently recognized and an accurate TRALI incidence has not been reported. Therefore, we carried out this study to assess the incidence of TRALI and to determine whether the CART algorithm can be applied to our hospital data.Study Design and Methods: A retrospective analysis of all patients who received any type of transfusion during anesthesia was performed. After the patients were diagnosed by the relevant diagnostic criteria, they were reclassified by the CART algorithm. The validity of the algorithm was evaluated with sensitivity, specificity, likelihood ratios, and misclassification rate.Results: Among 1948 patients who had received 11,269 units of transfusion, 26 TRALI and 20 TACO cases were identified. The incidence of TRALI among the transfused patients was 1.33% and per unit of transfused blood product was 0.23%. The sensitivity and specificity of the TRALI algorithm were estimated to be 73.1% (95% confidence interval [CI], 53.9%-86.3%) and 57.0% (95% CI, 52.5%-61.4%). For TACO, the sensitivity and specificity were 90.0% (95% CI, 69.9%-97.2%) and 56.0% (95% CI, 51.6%-60.4%), respectively.Conclusions: Low specificity of the CART algorithm adopted previously indicated its limited diagnostic value in the Republic of Korea. A new algorithm is needed to facilitate the detection of transfusion-related complications. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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