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Article: Value of preoperative coagulation tests: Reappraisal of major noncardiac surgery

TitleValue of preoperative coagulation tests: Reappraisal of major noncardiac surgery
Authors
Issue Date2002
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 2002, v. 26 n. 5, p. 515-520 How to Cite?
AbstractIn a retrospective case-control review, we evaluated pre-operative coagulation testing in patients undergoing major noncardiac operations to determine if routine testing benefits this group of patients. The platelet count (PC), prothrombin time (PT), and activated partial thromboplastin time (aPTT) in all patients undergoing major noncardiac surgery over a 22-month period were reviewed. The review was done both manually and by the computerized hospital information system. Major surgery was defined as procedures usually associated with significant bleeding. For each patient with abnormal results, another two control patients undergoing the same surgery and matched for age and gender were identified. Case and control patients were compared regarding a change in the management plan, use of blood products, blood loss, and bleeding complications by detailed chart review. A total of 828 patients undergoing nine different surgeries were reviewed. The incidence of abnormal PCs was 2.2% [95% confidence interval (CI) 1.2-3.2%] and that of abnormal PT/aPTTs was 2.1% (95% CI 1.1-3.1%). There were only two cases each of thrombocytopenia and prolonged PT/aPTT where the coagulation tests were not indicated clinically. Although (compared to controls) patients with abnormal tests had more changes in their anesthesia plan (36% vs. 2%, p < 0.001) and platelet or fresh frozen plasma transfusions (50% vs. 9%, p < 0.001), blood loss and the incidence of bleeding complications were not different. We conclude that the use of preoperative coagulation tests in patients undergoing major noncardiac surgery should still be guided by clinical assessment. The surgical procedure itself does not constitute an indication for testing.
Persistent Identifierhttp://hdl.handle.net/10722/67335
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorLai, KWen_HK
dc.contributor.authorTsang, SFen_HK
dc.date.accessioned2010-09-06T05:54:04Z-
dc.date.available2010-09-06T05:54:04Z-
dc.date.issued2002en_HK
dc.identifier.citationWorld Journal Of Surgery, 2002, v. 26 n. 5, p. 515-520en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/67335-
dc.description.abstractIn a retrospective case-control review, we evaluated pre-operative coagulation testing in patients undergoing major noncardiac operations to determine if routine testing benefits this group of patients. The platelet count (PC), prothrombin time (PT), and activated partial thromboplastin time (aPTT) in all patients undergoing major noncardiac surgery over a 22-month period were reviewed. The review was done both manually and by the computerized hospital information system. Major surgery was defined as procedures usually associated with significant bleeding. For each patient with abnormal results, another two control patients undergoing the same surgery and matched for age and gender were identified. Case and control patients were compared regarding a change in the management plan, use of blood products, blood loss, and bleeding complications by detailed chart review. A total of 828 patients undergoing nine different surgeries were reviewed. The incidence of abnormal PCs was 2.2% [95% confidence interval (CI) 1.2-3.2%] and that of abnormal PT/aPTTs was 2.1% (95% CI 1.1-3.1%). There were only two cases each of thrombocytopenia and prolonged PT/aPTT where the coagulation tests were not indicated clinically. Although (compared to controls) patients with abnormal tests had more changes in their anesthesia plan (36% vs. 2%, p < 0.001) and platelet or fresh frozen plasma transfusions (50% vs. 9%, p < 0.001), blood loss and the incidence of bleeding complications were not different. We conclude that the use of preoperative coagulation tests in patients undergoing major noncardiac surgery should still be guided by clinical assessment. The surgical procedure itself does not constitute an indication for testing.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subject.meshInternational Normalized Ratio-
dc.subject.meshPartial Thromboplastin Time-
dc.subject.meshPreoperative Care - methods-
dc.subject.meshProthrombin Time-
dc.subject.meshSurgical Procedures, Operative-
dc.titleValue of preoperative coagulation tests: Reappraisal of major noncardiac surgeryen_HK
dc.typeArticleen_HK
dc.identifier.emailNg, KFJ:jkfng@hkucc.hku.hken_HK
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00268-001-0260-8en_HK
dc.identifier.pmid12098036-
dc.identifier.scopuseid_2-s2.0-0036559315en_HK
dc.identifier.hkuros67162en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036559315&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume26en_HK
dc.identifier.issue5en_HK
dc.identifier.spage515en_HK
dc.identifier.epage520en_HK
dc.identifier.isiWOS:000175472900001-
dc.publisher.placeUnited Statesen_HK

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