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Preoperative hematological assessment of pediatric patients with cerebral palsy
Hakan Omeroğlu1, Ulukan Inan, Kemal Turgut
1Department of Orthopedics and Traumatology, Faculty of Medicine, Eskiflehir Osmangazi University, Eskiflehir, Turkey. homeroglu@superonline.com
Insights
Routine preoperative blood tests in children with cerebral palsy (CP) undergoing orthopedic surgery are similar to those of other orthopedic patients. Advanced hematological testing is only recommended if initial results are abnormal.
Area of Science:
- Pediatric Orthopedics
- Hematology
- Neurology
Background:
- Children with cerebral palsy (CP) may experience hematological alterations due to nutritional deficiencies and antiepileptic drugs.
- These alterations can increase the risk of intraoperative or postoperative complications.
Purpose of the Study:
- To evaluate preoperative routine blood tests in pediatric CP patients undergoing orthopedic procedures.
- To compare hematological status between CP patients with varying walking abilities and a control group.
Main Methods:
- Retrospective study comparing 62 CP patients with 130 orthopedic controls.
- Analysis of various hematological parameters including hemoglobin, hematocrit, WBC, and platelet counts.
- Comparison between CP patients categorized by Gross Motor Function Classification System (GMFCS) levels I/II and III/IV.
Main Results:
- No significant differences in preoperative hematological parameters were found between CP patients and the control group.
- Hematological parameters were similar between CP patients with GMFCS levels I/II and III/IV.
- No increased risk of hematological complications was identified in CP patients based on routine preoperative tests.
Conclusions:
- Preoperative blood test results in pediatric CP patients undergoing orthopedic interventions are comparable to those of non-CP orthopedic patients.
- Routine advanced preoperative hematological tests are not generally necessary for CP patients.
- Consider advanced testing only for CP patients with initially abnormal blood test results.
Objectives:
Nutritional deficiencies and use of antiepileptic drugs can lead to alterations in the hematological status of children with cerebral palsy (CP), which may increase the risk of intraoperative or postoperative hematological complications. In this retrospective study, we evaluated the preoperative routine blood tests of CP patients with different levels of walking ability, who were scheduled to undergo orthopedic procedures.
Methods:
Hemoglobin level, hematocrit, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, and plasma fibrinogen concentration were compared between 62 consecutive CP patients [28 girls, 34 boys; mean age 8.8 years (range 2-16 years)] and 130 consecutive orthopedic patients as control [64 girls, 66 boys; mean age 9.2 years (range 2-16 years)] who did not have any skeletal, cranial, thoracic, abdominal or major soft tissue injuries, or any other infectious, metabolic, hematological or malignant tumor disorders.
Results:
CP and control groups were similar with regard to the above-mentioned hematological parameters. In the CP group, no difference was found between Gross Motor Function Classification System for Cerebral Palsy (GMFCS) level I/II patients and GMFCS level III/IV patients in terms of these hematological parameters.
Conclusion:
Preoperative blood tests results of pediatric CP patients, walking with or without any supportive devices and undergoing orthopedic interventions, are similar to those of other orthopedic patients. Advanced preoperative hematological tests can only be recommended for CP patients with abnormal blood test results.
