Related Experiment Videos
Routine coagulation screening in children undergoing gastrointestinal endoscopy does not predict those at risk of
E Giles1, E Walton-Salih, N Shah
1Department of Gastroenterology, Great Ormond Street Hospital for Sick Children NHS Trust, London, United Kingdom.
Insights
Routine coagulation screening before pediatric gastrointestinal endoscopy is not beneficial and does not predict bleeding risk. This practice is common in the UK but should be reserved for high-risk children only.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pathology
Background:
- Routine coagulation screening before pediatric gastrointestinal endoscopy is common in the UK.
- There is a lack of evidence supporting this practice.
Purpose of the Study:
- To assess the benefits of routine pre-endoscopy coagulation screening in children.
- To determine the prevalence of this practice in UK pediatric centers.
Main Methods:
- Retrospective analysis of 250 pediatric endoscopy cases with coagulation screening.
- Telephone survey of 23 UK pediatric gastroenterology centers regarding their screening protocols.
Main Results:
- 16.8% of children had abnormal clotting results, which were not clinically significant or linked to increased bleeding.
- 21.7% of surveyed UK pediatric centers routinely screen for coagulation prior to endoscopy.
Conclusions:
- Routine coagulation screening is not indicated for children undergoing gastrointestinal endoscopy and biopsy.
- The practice does not identify children at risk of significant bleeding and should be reserved for high-risk individuals.
Background And Study Aims:
Routine coagulation screening prior to gastrointestinal endoscopy is performed in many centres in the UK, despite the lack of any evidence to support the practice. The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening in children and to assess how widespread this practice is in the UK.
Patients And Methods:
We performed a retrospective analysis of the case notes of 250 consecutive patients who had undergone routine coagulation screening prior to endoscopy and biopsy, in accordance with our unit's protocol, looking for evidence of abnormal results or episodes of bleeding. We also performed a telephone survey of the protocols for coagulation screening at other paediatric units in the UK which are known to perform gastrointestinal endoscopy on a routine basis.
Results:
According to our hospital's laboratory reference ranges, 16.8 % of the children who underwent endoscopy and biopsy had abnormal clotting. This was neither clinically significant nor associated with an increased bleeding risk in any patient. Of the 23 UK paediatric gastroenterology centres surveyed, including our own, five (21.7 %) perform routine coagulation screening before endoscopy.
Conclusions:
This study suggests that, although it is a relatively common practice, routine coagulation screening is not indicated in children who are undergoing gastrointestinal endoscopy and biopsy, and that it does not predict those at risk of significant bleeding. We would therefore suggest that if pre-endoscopy screening is to be performed, it should be reserved for those who are potentially at high risk of bleeding.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to: