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Preoperative screening for coagulation disorders in children undergoing adenoidectomy (AT) and tonsillectomy (TE):

S Eisert1, M Hovermann, H Bier

  • 1Department of Pediatric Oncology, Hematology and Immunology, Children's University Hospital, Heinrich Heine University Düsseldorf. susanne.eisert@uni-duesseldorf.de

Klinische Padiatrie
|November 3, 2006
PubMed

Insights

Preoperative coagulation screening in children undergoing adenotonsillectomy (AT) and/or tonsillectomy (TE) did not effectively identify those at risk for bleeding complications. Standard tests failed to predict major bleeding events in this pediatric surgical population.

Area of Science:

  • Pediatric Surgery
  • Hematology
  • Otolaryngology

Background:

  • Bleeding is a significant complication following adenotonsillectomy (AT) in children.
  • Preoperative coagulation tests are commonly used to screen for bleeding disorders.
  • The efficacy of these tests in preventing surgical bleeding remains under investigation.

Purpose of the Study:

  • To evaluate the effectiveness of preoperative coagulation screening in identifying children at risk of bleeding complications from adenotonsillectomy (AT) and/or tonsillectomy (TE).

Main Methods:

  • Prospective study of two groups of children undergoing AT/TE: one group with routine preoperative screening, and another with prolonged activated partial thromboplastin time (aPTT).
  • Coagulation disorders were assessed via bleeding history and laboratory tests.
  • Surgical bleeding events were retrospectively analyzed.

Main Results:

  • Coagulation disorders were identified in 4.7% of children in the routine screening group and 12.1% in the prolonged aPTT group.
  • Major bleeding occurred in 1 of 141 patients (0.7%) in the routine group and 4 of 79 patients (5.1%) in the prolonged aPTT group.
  • Preoperative screening tests had zero sensitivity for detecting major bleeding in the routine screening group.

Conclusions:

  • Current preoperative coagulation screening protocols are insufficient for predicting major bleeding in pediatric patients undergoing adenotonsillectomy and/or tonsillectomy.
  • Further research is needed to develop more effective methods for identifying at-risk patients.
Abstract

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