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Abnormal coagulation profiles in tonsillectomy and adenoidectomy patients
J L Schmidt1, K L Yaremchuk, S A Mickelson
1Department of Otolaryngology, Henry Ford Hospital, Detroit, MI 48202.
Henry Ford Hospital Medical Journal
|January 1, 1990
Summary
Routine preoperative coagulation screening is essential before tonsillectomy and adenoidectomy. Coagulopathies occur frequently, justifying screening even without a positive patient history for bleeding disorders.
Area of Science:
- Otolaryngology
- Hematology
- Surgical Patient Management
Background:
- Routine preoperative coagulation screening is standard practice in US otolaryngology for tonsillectomy and adenoidectomy.
- Recent debate questions the necessity of this routine testing.
Observation:
- A review of 91 patients undergoing tonsillectomy and/or adenoidectomy was conducted.
- Abnormal preoperative coagulation profiles were identified in four patients.
Findings:
- One patient had von Willebrand disease.
- One patient had hypofibrinoginemia.
- Two patients presented with a transient acquired lupus-like anticoagulant, prolonging activated partial thromboplastin time.
Implications:
- Coagulopathies are sufficiently common to warrant preoperative screening.
- Screening is recommended even when patients lack a history suggestive of bleeding disorders.
- This supports the continued routine use of coagulation profile testing before these procedures.