{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:21:37Z","timestamp":1792423297792,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Among patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC), perioperative bleeding requiring blood transfusion is a common complication, yet preoperative identification of patients at risk for transfusion remains challenging. The objective of this study was to develop a preoperative risk score for blood transfusion requirement during surgery for ICC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing curative\u2010intent liver surgery for ICC (1990\u20132020) were identified from a multi\u2010institutional database. A predictive model was developed and validated. An easy\u2010to\u2010use risk calculator was made available online.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1420 patients, 300 (21.1%) received an intraoperative transfusion. Independent predictors of transfusion included severe preoperative anemia (OR\u2009=\u20091.65, 95% CI 1.10\u20132.47), T2 category or higher (OR\u2009=\u20092.00, 95% CI 1.36\u20133.02), positive lymph nodes (OR\u2009=\u20091.75, 95% CI 1.32\u20132.32) and major resection (OR\u2009=\u20092.56, 95%CI 1.85\u20133.58). Receipt of blood transfusion significantly correlated with worse outcomes. The model showed good discriminative ability in both training (AUC\u2009=\u20090.68, 95% CI 0.66\u20130.72) and bootstrapping validation (C\u2010index\u2009=\u20090.67, 95% CI 0.65\u20130.70) cohorts. An online risk calculator of blood transfusion requirement was developed (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/catalano-giovanni.shinyapps.io\/TransfusionRisk\">https:\/\/catalano-giovanni.shinyapps.io\/TransfusionRisk<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative blood transfusion was significantly associated with poor postoperative outcomes among patients undergoing surgery for ICC. The identification of patients at high risk of transfusion could improve perioperative patient care and blood resources allocation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27903","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:40:54Z","timestamp":1726594854000},"page":"242-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Validation of a Predictive Risk Score for Blood Transfusion in Patients Undergoing Curative\u2010Intent Surgery for Intrahepatic Cholangiocarcinoma"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-7031","authenticated-orcid":false,"given":"Giovanni","family":"Catalano","sequence":"first","affiliation":[{"name":"Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio USA"},{"name":"Department of Surgery University of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Alaimo","sequence":"additional","affiliation":[{"name":"Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio USA"},{"name":"Department of Surgery University of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odysseas P.","family":"Chatzipanagiotou","sequence":"additional","affiliation":[{"name":"Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio 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Clinical Institute Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Poultsides","sequence":"additional","affiliation":[{"name":"Department of Surgery Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3591-8925","authenticated-orcid":false,"given":"Shishir K.","family":"Maithel","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo P.","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Surgery Curry Cabral Hospital Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Martel","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Ottawa Ottawa Ontario 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