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Published on: November 6, 2019
[Frequency of coagulopathies in cases with post-tonsillectomy bleeding]
Imre Gerlinger1, László Török, Agnes Nagy
1Pécsi Tudományegyetem, Altalános Orvostudományi Kar, Fül-orr-gégészeti és Fej-nyaksebészeti Klinika, Pécs. i.gerlinger@freemail.hu
Orvosi Hetilap
|February 29, 2008
Summary
Preoperative hematological screening for tonsillectomy patients is not cost-effective, but screening is recommended for children with suspicious histories to detect hidden coagulopathies. Activated partial thromboplastin time (APTT) was the most sensitive indicator.
Area of Science:
- Otorhinolaryngology
- Hematology
- Surgical Complications
Context:
- Post-tonsillectomy hemorrhage is a serious complication, with secondary bleeding occurring 5-8 days post-surgery.
- Risk factors for secondary bleeding are poorly understood.
- Identifying coagulopathies preoperatively could mitigate bleeding risks.
Purpose:
- To evaluate the utility of preoperative hematological screening for detecting hidden coagulopathies in patients undergoing tonsillectomy.
- To determine if such screening is a reasonable practice.
Summary:
- 49% of screened patients had abnormal results, but only 3.4% were diagnosed with unknown coagulopathies after re-examination.
- Activated partial thromboplastin time (APTT) showed the highest sensitivity.
- Secondary bleeding was more common after "hot" surgical techniques.
Impact:
- Universal preoperative screening is not cost-effective.
- Screening is advised for children with concerning family or medical histories.
- Diagnosing coagulopathies aids in identifying affected family members.
- Findings may influence surgical technique choices and patient selection for screening.
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