title: Transfusion Risk and Clinical Knowledge (TRACK) Score and Cardiac Surgery in Patients Refusing Transfusion.
abstract: OBJECTIVE
  The Transfusion Risk and Clinical Knowledge (TRACK) score is a simple tool to predict the chance of undergoing blood transfusion in cardiac surgery. The authors evaluated the relationship between the TRACK score and clinical outcomes of cardiac surgery in patients who refused blood transfusion.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  A single hospital.
  
  
  METHODS
  Seventy-six adult Jehovah's Witnesses refusing blood transfusion who underwent cardiac surgeries.
  
  
  METHODS
  Patients were divided into 2 groups according to their TRACK score: low-risk group (n = 57, TRACK score of less than 13) and high-risk group (n = 19, TRACK score of 13 or more). Perioperative and long-term clinical outcomes were compared between the 2 groups.
  
  
  RESULTS
  The operative mortality was 0% in the low-risk group, and 21.1% (n = 4) in the high-risk group (p = 0.003). The incidence of major postoperative complications was higher in the high-risk group (57.9%) than in the low-risk group (17.5%) (p = 0.002). The high-risk group had more postoperative bleeding-related complications (21.1%) than did the low-risk group (1.8%) (p = 0.013). There were no significant differences of predictive performance in mortality and morbidity between the TRACK score and EuroSCORE II.
  
  
  CONCLUSIONS
  In cardiac surgery patients refusing transfusions, the TRACK score predicted postoperative morbidity and mortality of cardiac surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea;. Electronic address: kmdphd@gmail.com.
authors.forename: Tae Sik
authors.initials: TS
authors.lastname: Kim
authors.affiliation: †Department of Anesthesiology, Sejong General Hospital, Bucheon, Republic of Korea;
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: ‡Department of Biostatistics, Korea University Medical Center, Seoul, Republic of Korea.
authors.forename: Hyonggin
authors.initials: H
authors.lastname: An
authors.affiliation: §Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Chan-Young
authors.initials: CY
authors.lastname: Na
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk; D065227:Transfusion Reaction; D016896:Treatment Outcome; D016312:Treatment Refusal
keywords: adult; blood transfusion; cardiac surgery; cardiopulmonary bypass; perioperative care