title: Prediction score for effective bleeding control using recombinant activated factor VII in perioperative nonhemophilic patients.
abstract: BACKGROUND
  Although there has been growing evidence from off-label use of recombinant activated factor VII (rFVIIa) in surgical bleeding, there is limited information on prediction scores.
  
  
  METHODS
  A retrospective study was conducted from 2004 to 2009. The primary outcome was efficacy of bleeding control. Multivariate logistic regression was performed to develop a new prediction score for success of rFVIIa.
  
  
  RESULTS
  A total of 320 bleeding episodes from 243 nonhemophilic patients who underwent surgery were analyzed. Effective bleeding control was demonstrated in 153 patients. The overall in-hospital mortality rate was 40%. Multivariate analysis identified 4 independent predictors for effective bleeding control: timing of rFVIIa administration, intraoperative blood loss, postoperative international normalization ratio values, and total units of platelets transfused. A rFVIIa success prediction score was developed.
  
  
  CONCLUSIONS
  The use of this new prediction score may support decision making by identifying patients with a high probability of obtaining effective bleeding control from rFVIIa therapy.
authors.affiliation: Department of Anaesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Panthila
authors.initials: P
authors.lastname: Rujirojindakul
authors.forename: Pairaya
authors.initials: P
authors.lastname: Rujirojindakul
authors.forename: Edward B
authors.initials: EB
authors.lastname: McNeil
authors.forename: Alan F
authors.initials: AF
authors.lastname: Geater
authors.forename: Thavat
authors.initials: T
authors.lastname: Chanchayanon
authors.forename: Burapat
authors.initials: B
authors.lastname: Sangthong
authors.forename: Voravit
authors.initials: V
authors.lastname: Chittithavorn
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D056687:Off-Label Use; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000401:mortality; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: Blood loss; Mortality; Off-label; Recombinant activated factor VII; Surgery; Transfusion