Faculty Collaboration Database

An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy. Int J Pediatr Otorhinolaryngol 1987 Oct;13(3):237-44

Date

10/01/1987

Pubmed ID

3679679

DOI

10.1016/0165-5876(87)90104-2

Scopus ID

2-s2.0-0023425633 (requires institutional sign-in at Scopus site)   82 Citations

Abstract

Preoperative coagulation studies are commonly employed in order to try to identify the 2-4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. For patients with no history or clinical signs indicating possible bleeding disorder, preoperative PT and PTT failed to predict bleeding as an outcome. Also no patients were identified in this series to have previously undiagnosed coagulopathies on the basis of screening PT/PTT. The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies.

Author List

Manning SC, Beste D, McBride T, Goldberg A

Author

David J. Beste MD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoidectomy
Blood Coagulation Disorders
Blood Coagulation Tests
Child
Child, Preschool
Evaluation Studies as Topic
Hemorrhage
Humans
Partial Thromboplastin Time
Postoperative Complications
Predictive Value of Tests
Preoperative Care
Prothrombin Time
Retrospective Studies
Tonsillectomy