[Preoperative coagulation screening prior to adenoidectomy and tonsillectomy]

Area of Science:

• Pediatric Surgery
• Hematology
• Clinical Diagnostics

Background:

• Routine laboratory coagulation tests are standard for screening pediatric surgical patients.
• The predictive accuracy of common coagulation tests (thromboplastin time, partial thromboplastin time, thrombocyte count) versus bleeding history is under investigation.

Purpose of the Study:

• To evaluate the effectiveness of preoperative coagulation screening in predicting postoperative bleeding in children undergoing adenoidectomy and tonsillectomy.
• To compare the predictive value of laboratory tests with a standardized bleeding history.

Main Methods:

• A cohort of 702 pediatric patients undergoing 500 adenoidectomies and 500 tonsillectomies were analyzed.
• Results from laboratory coagulation tests and individual bleeding histories were collected and evaluated.

Main Results:

• Abnormal results were found in 9.4% of laboratory tests.
• A suspicious bleeding history was reported in 30.5% of children for adenoidectomy and 22% for tonsillectomy.
• Post-tonsillectomy bleeding occurred in 5.4% of patients; history alone predicted 9.2% of bleeding events, while coagulation screening predicted only 6.8%.

Conclusions:

• Preoperative laboratory coagulation tests have limited value in predicting postoperative bleeding complications in children.
• A comprehensive bleeding history is more effective in identifying at-risk patients.
• Targeted laboratory testing based on patient history, alongside counseling and postoperative monitoring, can improve patient safety.