File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Value of a single preoperative PFA-100® measurement in assessing the risk of bleeding in patients taking cyclooxygenase inhibitors and undergoing total knee replacement

TitleValue of a single preoperative PFA-100® measurement in assessing the risk of bleeding in patients taking cyclooxygenase inhibitors and undergoing total knee replacement
Authors
KeywordsBlood, anticoagulants
Blood, platelets
Complications, haemorrhage
Non-steroidal anti-inflammatory drugs
Surgery, postoperative period
Issue Date2009
PublisherOxford University Press. The Journal's web site is located at http://bja.oxfordjournals.org/
Citation
British Journal Of Anaesthesia, 2009, v. 102 n. 6, p. 779-784 How to Cite?
AbstractBackground. The usefulness of the PFA-100® in assessing the risk of bleeding in non-cardiac surgery is not clear. This study aims to examine this by correlating preoperative PFA-100® measurement with perioperative bleeding in patients receiving cyclooxygenase (COX) inhibitors. Methods. PFA-100® with adenosine-5'-diphosphate (ADPCT) and epinephrine (EPICT) cartridges were measured before operation in consecutive patients undergoing elective total knee replacement and taking different COX inhibitors. Surgery and anaesthesia were performed by the same team using standardized techniques. Intraoperative blood loss and postoperative drain output were recorded by anaesthetists and nurses blinded to the PFA-100 ® measurements. Surgeons, similarly blinded, were asked to rate the quality of haemostasis. Correlation was sought between these data and PFA-100® measurements. Results. Thirty patients were studied, involving 51 knees. Preoperative PFA-100® EPICT was correlated with drain output (r=0.30, P=0.03). The correlation becomes stronger when a 20 in vitro haemodiluted sample was used for measurement (r=0.42, P=0.01). Receiver-operating characteristic curve analysis using the diluted measurements [area under curve (AUC) 0.74 (95 CI 0.54-0.94)] suggested using a cut-off value of 188 s for EPICT, which will predict excessive drain output with 89 sensitivity, 54 specificity, and a likelihood ratio of 1.93. Diluted EPICT was also correlated with surgeon rating of haemostasis (r=0.36, P=0.04) although none of the measurements correlated with intraoperative blood loss. Conclusions. Preoperative PFA-100® prolongation is correlated with increased postoperative drain output. It can be a potentially useful preoperative measurement in patients taking COX inhibitors.
Persistent Identifierhttp://hdl.handle.net/10722/147266
ISSN
2015 Impact Factor: 5.616
2015 SCImago Journal Rankings: 2.314
ISI Accession Number ID
Funding AgencyGrant Number
Queen Mary Hospital Charitable Trust Training and Research Assistance SchemeTRAS-07-0201/13/100
Funding Information:

This study is supported in part by a Queen Mary Hospital Charitable Trust Training and Research Assistance Scheme (TRAS-07-0201/13/100),which has no role in the design, conduct, or analysis of the study, and in part by departmental funds. None of the authors has received any sponsorship or other financial support from the manufacturers or distributors of the PFA-100 (R).

References

 

DC FieldValueLanguage
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorLawmin, JCen_HK
dc.contributor.authorTsang, SFen_HK
dc.contributor.authorTang, WMen_HK
dc.contributor.authorChiu, KYen_HK
dc.date.accessioned2012-05-29T06:01:07Z-
dc.date.available2012-05-29T06:01:07Z-
dc.date.issued2009en_HK
dc.identifier.citationBritish Journal Of Anaesthesia, 2009, v. 102 n. 6, p. 779-784en_HK
dc.identifier.issn0007-0912en_HK
dc.identifier.urihttp://hdl.handle.net/10722/147266-
dc.description.abstractBackground. The usefulness of the PFA-100® in assessing the risk of bleeding in non-cardiac surgery is not clear. This study aims to examine this by correlating preoperative PFA-100® measurement with perioperative bleeding in patients receiving cyclooxygenase (COX) inhibitors. Methods. PFA-100® with adenosine-5'-diphosphate (ADPCT) and epinephrine (EPICT) cartridges were measured before operation in consecutive patients undergoing elective total knee replacement and taking different COX inhibitors. Surgery and anaesthesia were performed by the same team using standardized techniques. Intraoperative blood loss and postoperative drain output were recorded by anaesthetists and nurses blinded to the PFA-100 ® measurements. Surgeons, similarly blinded, were asked to rate the quality of haemostasis. Correlation was sought between these data and PFA-100® measurements. Results. Thirty patients were studied, involving 51 knees. Preoperative PFA-100® EPICT was correlated with drain output (r=0.30, P=0.03). The correlation becomes stronger when a 20 in vitro haemodiluted sample was used for measurement (r=0.42, P=0.01). Receiver-operating characteristic curve analysis using the diluted measurements [area under curve (AUC) 0.74 (95 CI 0.54-0.94)] suggested using a cut-off value of 188 s for EPICT, which will predict excessive drain output with 89 sensitivity, 54 specificity, and a likelihood ratio of 1.93. Diluted EPICT was also correlated with surgeon rating of haemostasis (r=0.36, P=0.04) although none of the measurements correlated with intraoperative blood loss. Conclusions. Preoperative PFA-100® prolongation is correlated with increased postoperative drain output. It can be a potentially useful preoperative measurement in patients taking COX inhibitors.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://bja.oxfordjournals.org/en_HK
dc.relation.ispartofBritish Journal of Anaesthesiaen_HK
dc.subjectBlood, anticoagulantsen_HK
dc.subjectBlood, plateletsen_HK
dc.subjectComplications, haemorrhageen_HK
dc.subjectNon-steroidal anti-inflammatory drugsen_HK
dc.subjectSurgery, postoperative perioden_HK
dc.titleValue of a single preoperative PFA-100® measurement in assessing the risk of bleeding in patients taking cyclooxygenase inhibitors and undergoing total knee replacementen_HK
dc.typeArticleen_HK
dc.identifier.emailNg, KFJ:jkfng@hkucc.hku.hken_HK
dc.identifier.emailChiu, KY:pkychiu@hkucc.hku.hken_HK
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.identifier.authorityChiu, KY=rp00379en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1093/bja/aep091en_HK
dc.identifier.pmid19411670-
dc.identifier.scopuseid_2-s2.0-67649450291en_HK
dc.identifier.hkuros162152-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-67649450291&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume102en_HK
dc.identifier.issue6en_HK
dc.identifier.spage779en_HK
dc.identifier.epage784en_HK
dc.identifier.eissn1471-6771-
dc.identifier.isiWOS:000266344500010-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridNg, KFJ=13608809400en_HK
dc.identifier.scopusauthoridLawmin, JC=6503956048en_HK
dc.identifier.scopusauthoridTsang, SF=7102255980en_HK
dc.identifier.scopusauthoridTang, WM=7403430820en_HK
dc.identifier.scopusauthoridChiu, KY=7202988127en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats