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Titre du document / Document title

The need for routine pre-operative coagulation screening tests (prothrombin time PT/partial thromboplastin time PTT) for healthy children undergoing elective tonsillectomy and/or adenoidectomy

Auteur(s) / Author(s)

ASAF Toker (1) ; REUVENI Haim (2) ; YERMIAHU Tikva (3) ; LEIBERMAN Alberto (4) ; GURMAN Gabriel (5) ; PORAT Avi (6) ; SCHLAEFFER Pnina (7) ; SHIFRA Shvarts (2) ; KAPELUSHNIK Joseph (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Pediatric Hemato-Oncology Unit, Soroka University Medical Center, P.O. Box 151, Beer-Shera 84101, ISRAEL
(2) Department of Health Policy and Health Management, Ben-Gurion University, Beer-Sheva, ISRAEL
(3) Hematology Laboratory, Soroka University Medical Center, Beer-Sheva, ISRAEL
(4) Department of Ear, Nose and Throat, Soroka University Medical Center, Beer-Sheva, ISRAEL
(5) Division of Anesthesiology, Soroka University Medical Center, Beer-Sheva, ISRAEL
(6) Internal Medicine Vav, Soroka University Medical Center, Beer-Sheva, ISRAEL
(7) Quality Assurance Unit, Soroka University Medical Center, Beer-Sheva, ISRAEL

Résumé / Abstract

In some medical centers, the routine pre-operative evaluation of healthy children undergoing elective tonsillectomy and/or adenoidectomy (T and A) includes coagulation screening tests (PT, prothrombin Time; PTT, partial thromboplastin time; and INR, international normalized ratio). In this retrospective study, we determined whether there is a positive correlation between prolonged PT/PTT/INR tests in healthy children, with no prior medical history of coagulation problems, and bleeding during surgery and/or bleeding in the month following surgery. We reviewed the records of 416 elective T and A surgeries performed at the Soroka University Medical Center in Beer-Sheva, Israel, over the course of 1999. One hundred and twenty-one (29.1%) patients had preoperative prolonged PT values but only four (3.3%) of these patients experienced light bleeding during surgery. Seven (5.8%) of the 121 patients with prolonged PT tests experienced bleeding episodes during the 1st month subsequent to the surgery. Of the 65 (15.6%) patients who had prolonged pre-operative INR values, only three (4.6%) experienced light bleeding during surgery. Two (3.1%) patients with prolonged INR values experienced light bleeding during the 1st month subsequent to surgery. Sixty-one (14.7%) patients had prolonged first preoperative PTT values, only five of whom (8.2%) experienced light bleeding during surgery. Two (3.3%) of the 61 with prolonged PTT values experienced light bleeding during the 1st month subsequent to surgery. We therefore concluded that pre-operative coagulation screening tests provide low sensitivity and low bleeding predictive value. As such, routine coagulation tests before T &A are not indicated unless a medical history of bleeding tendency is suspected.

Revue / Journal Title

International journal of pediatric otorhinolaryngology    ISSN  0165-5876   CODEN IPOTDJ 

Source / Source

2001, vol. 61, no3, pp. 217-222 (14 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Oxford, ROYAUME-UNI  (1979) (Revue)

Mots-clés anglais / English Keywords

Hemopathy

;

Surgery

;

Human

;

Adenoid enlargement

;

Child

;

Treatment

;

Retrospective

;

Medical screening

;

Coagulopathy

;

Indication

;

Preoperative

;

Coagulation test

;

Prothrombin time

;

Adenoidectomy

;

Selection

;

Tonsillectomy

;

Mots-clés français / French Keywords

Hémopathie

;

Chirurgie

;

Homme

;

Végétation adénoïde

;

Enfant

;

Traitement

;

Rétrospective

;

Dépistage

;

Coagulopathie

;

Indication

;

Préopératoire

;

Test coagulation

;

Temps prothrombine

;

Adénoïdectomie

;

Sélection

;

Amygdalectomie

;

Mots-clés espagnols / Spanish Keywords

Hemopatía

;

Cirugía

;

Hombre

;

Vegetación adenoide

;

Niño

;

Tratamiento

;

Retrospectiva

;

Descubrimiento

;

Coagulopatía

;

Indicación

;

Preoperatorio

;

Prueba coagulación

;

Tiempo protrombina

;

Adenoidectomía

;

Selección

;

Amigdalectomía

;

Localisation / Location

INIST-CNRS, Cote INIST : 18290, 35400010296383.0040

Nº notice refdoc (ud4) : 14136111



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