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Characteristics of children diagnosed as having coagulopathies following posttonsillectomy bleeding

Gordon H Sun1, Brian M Harmych, J Matthew Dickson

  • 1Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Ohio, USA. Gordon.H.Sun@gmail.com

Archives of Otolaryngology--Head & Neck Surgery
|January 19, 2011
PubMed

Insights

Post-tonsillectomy bleeding (PTB) in children may indicate underlying coagulopathy. Activated partial thromboplastin time and platelet function assays are key diagnostic tools for identifying these occult bleeding disorders.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Hematology
  • Clinical Diagnostics

Background:

  • Post-tonsillectomy bleeding (PTB) is a common complication in pediatric patients.
  • Identifying underlying coagulopathies is crucial for effective management of PTB.
  • Occult bleeding disorders may present atypically, complicating diagnosis.

Purpose of the Study:

  • To determine the prevalence of coagulopathy in children with PTB.
  • To identify risk factors associated with occult coagulopathy in this population.

Main Methods:

  • Retrospective medical chart review at a tertiary-care pediatric hospital.
  • Analysis of 182 pediatric patients presenting with PTB between January and December 2007.
  • Inclusion of demographics, laboratory results (prothrombin time, activated partial thromboplastin time, platelet function assays), and clinical outcomes.

Main Results:

  • Four percent (8 of 182) of children were diagnosed with a coagulopathy.
  • Coagulopathic children showed significantly higher activated partial thromboplastin time and abnormal platelet function assays (PFAs).
  • No significant differences in age, sex, race, or time post-tonsillectomy were found between groups.

Conclusions:

  • Activated partial thromboplastin time and PFA studies, along with hematology consultations, aid in diagnosing occult coagulopathies in children with PTB.
  • The definition of PTB should encompass any history of oral bleeding, irrespective of physical examination findings.
Abstract

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