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Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet function testing in patients with post-operative tonsillectomy bleeding may be a useful early identifier of
T W James1, B J Thomson2, D N Naumann1
1Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, UK.
Insights
Post-tonsillectomy bleeding may indicate undiagnosed inherited platelet function disorders. Testing patients with bleeds revealed a significantly higher prevalence of these disorders, aiding early management.
Area of Science:
- Hematology
- Otolaryngology
- Genetics
Background:
- Post-tonsillectomy bleeding is a common complication.
- Inherited platelet function disorders affect approximately 1% of the population.
- The link between post-tonsillectomy bleeds and these disorders was previously unexamined.
Purpose of the Study:
- To determine the prevalence of inherited platelet function disorders in patients experiencing post-tonsillectomy bleeding.
Main Methods:
- An observational cohort study analyzed hospital records.
- Platelet function analyzer 100 (PFA-100) testing was performed on patients with post-tonsillectomy bleeds.
Main Results:
- 9.89% of 91 patients tested positive on PFA-100.
- 5.49% had undiagnosed inherited platelet function disorders.
- NSAID use caused false positives in 4 patients; specificity was 95.3%.
Conclusions:
- The prevalence of inherited platelet function disorders is five times higher in post-tonsillectomy bleed patients than in the general population.
- PFA-100 testing upon presentation with bleeding aids in managing these disorders.
Background:
Post-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before.
Objectives:
To assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients.
Methods:
An observational cohort study was conducted using hospital digital records. Platelet function analyser 100 ('PFA-100') closure time was tested on post-tonsillectomy bleed patients who presented to hospital.
Results:
Between 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent.
Conclusion:
The prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.
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