Researchers say they have developed a tool that can predict the need for blood transfusion during or after primary debulking surgery in patients with ovarian cancer.

The tool, called the “BLOODS score,” was developed to help identify patients who may benefit from preoperative planning and blood-saving techniques, according to Ryan Kahn, MD, of Memorial Sloan Kettering Cancer Center in New York, New York.

Dr Kahn described the BLOODS score at the SGO 2022 Annual Meeting on Women’s Cancer.


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The score was created using data from a single-center database of patients undergoing primary debulking surgery for ovarian cancer between 2001 and 2019. The odds of blood transfusion were calculated using a multivariate regression model.

Of the 1289 eligible patients, 84% underwent optimal primary debulking surgery, and 51% had complete gross resection. The median estimated blood loss was 650 cc.

In the multivariate analysis, there were 7 characteristics that were associated with blood transfusion:

  • American Society of Anesthesiologists physical score of 3 or higher (odds ratio [OR], 1.05; 95% CI, 1.00-1.10)
  • Preoperative serum albumin level of 3.5 g/dL or lower (OR, 1.26; 95% CI, 1.19-1.34)
  • Presence of ascites (OR, 1.06; 95% CI, 0.98-1.15)
  • Preoperative CA-125 level of 600 U/mL or higher (OR, 1.10; 95% CI, 1.04-1.16)
  • Carcinomatosis (OR, 1.01; 95% CI, 0.93-1.10)
  • Preoperative creatinine level greater than 0.90 mg/dL (OR, 1.14; 95% CI, 1.07-1.22)
  • Upper abdominal disease of 1 cm or greater (OR, 1.16; 95% CI, 1.07-1.25).

These 7 characteristics were combined to create the BLOODS score, with each variable assigned a score of 1 if present. The sum of the score corresponds to the need for blood transfusion.

Dr Kahn said a BLOODS score of 3 or higher is estimated to identify 80% of patients who require a blood transfusion, including 85% of patients who need a transfusion intraoperatively and 78% who need one postoperatively.

Dr Kahn concluded that the BLOODS score could be used to assist with presurgical planning and patient counseling.

Disclosures: Dr Kahn reported having no conflicts of interest.

Reference

Kahn R, Boerner T, Gordhandas S, et al. A preoperative tool for estimating the risk of blood transfusion over an ovarian cancer debulking surgery (BLOODS score). Presented at SGO 2022; March 18-21, 2022. Abstract 113.

This article originally appeared on Cancer Therapy Advisor