Prediction of elective surgical red blood cell transfusion reveals surgeon-level variation

BACKGROUND Preoperative prediction of red blood cell (RBC) transfusion in elective surgery serves two complementary purposes: enabling patient blood management (PBM) interventions before surgery and supporting blood product supply planning for elective lists. Beyond patient risk factors, individual surgeon practice may also contribute to transfusion rates, but this effect has not been fully quantified. STUDY DESIGN AND METHODS In a retrospective cohort of 279,905 elective surgical procedures at Helsinki University Hospital (2021-2025), we trained four gradient-boosted tree (CatBoost) models cr

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