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[Are blood tests prior to ear operations in children necessary?--A retrospective analysis]
M Schwaab1, S Shagdarsuren, S Hansen
1Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum, Germany. matthiasschwaab@gmx.de
Insights
Preoperative blood tests do not impact management for elective pediatric ear surgeries. A detailed patient history is crucial for assessing risks, potentially supplemented by targeted blood tests.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Hematology
Context:
- Elective pediatric ear operations are common, yet routine preoperative blood tests are often performed without clear clinical indications.
- A joint statement addressed the necessity of coagulation tests for adenoidectomy/tonsillectomy, prompting investigation into their utility for ear surgeries.
Purpose:
- To evaluate the influence of preoperative blood tests on the management of elective ear operations in children.
- To determine if routine blood tests predict postoperative complications like bleeding or infections.
Summary:
- A retrospective analysis of 81 children undergoing ear operations examined various blood parameters and clinical history against postoperative outcomes.
- Despite 10.5% of registered parameters differing from reference values, no abnormal bleeding or complications were predicted by these tests.
Impact:
- Findings suggest that preoperative blood tests have no significant influence on managing elective pediatric ear surgeries.
- Emphasizes the importance of a thorough patient and family medical history, potentially augmented by selective, calculated blood analyses.
Background:
Operations in children are often drastic events for patients and their parents. Most ENT operations are elective. Often blood tests are done even though there is no clinical evidence for coagulation disorders or anaemia in the medical history of the patient and their family. Since the joint statement of the German Societies of Oto-Rhino-Laryngology, Head and Neck surgery, of pediatrics and of anesthesiology regarding the necessity of coagulation tests prior to adenoidectomy or tonsillectomy in children we wanted to know whether blood tests have any effect for ear operations.
Methods And Patients:
Data of 81 children were analysed, undergoing an ear operation during 2006/2007 at the department of Oto-Rhino-Laryngology in Bochum, retrospectively. Information on sex, age, hemoglobin concentration, platelet count, INR, thromboplastin time, prothrombin time, count of the white blood cells, Cholinesterase (CHE), Glutamat-Oxalacetat-Transaminase (GOT), Glutamat-Pyruvat-Transaminase (GPT), gamma-Glutamyltransferase (GT), Creatinkinase (CK), creatinine, c-reactive protein (CRP) and clinical history of postoperative complications (bleeding, infections) were collected.
Results:
Out of 698 registered parameters 10,5 % were differing from the reference parameters. There were no abnormal bleedings or complications which could have been predicted by blood tests.
Conclusions:
The preoperative blood tests have no influence on the management of an elective ear operation. A thorough medical patient's and family history should be taken and may be added by a calculated analysis of special blood tests.
