Application of the McCluskey Index to predict blood product requirements during liver transplantation.
BACKGROUND
A recent study proposed a risk index (McCluskey index) based on 7 parameters to identify the transfusion needs of patients during surgery and in the first 24 hours postoperation. The initial objective of our study was to validate this predictor for blood product transfusions.


METHODS
We undertook a retrospective, observational study of all liver transplant patients between January 1, 2005 and December 31, 2006. The following variables were recorded for each patient: age, gender, patient comorbidity, biochemical values prior to liver transplantation, and transfusion needs.


RESULTS
Comparing the transfusion needs of those patients with scores <5 with those of scores >/=5, we observed significant differences in terms of the use of red blood cell concentrates, plasma, and platelets, both during the first 24 hours and in the total number. The index sensitivity was 80% (95% confidence interval [CI]: 71.23-88.76), with a specificity of 84.21% (95% CI: 67.81-100), where the positive predictive value was 95.52% (95% CI: 90.57-100.4) and the negative predictive value was 50% (95% CI: 32.67-67.32).


CONCLUSIONS
The McCluskey index showed sufficient sensitivity and specificity to predict which patients will require a massive transfusion.
Escoresca Ortega
A M
AM
Intensive Care and Emergency Department, Hospital Universitario Virgen del Rocío, Seville, Spain. nanaesco99@gmail.com
Mogollón Jiménez
M V
MV
Hinojosa Pérez
R
R
Ferrándiz Millón
C M
CM
Salgado Algarrada
J C
JC
Herruzo Avilés
A
A
Porras López
F M
FM
Perez Bernal
J B
JB
Gómez Bravo
M A
MA
D001803:Blood Transfusion / Q000706:statistics & numerical data*; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008487:Medical History Taking; D017713:Platelet Transfusion; D011237:Predictive Value of Tests; D012189:Retrospective Studies