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Routine Screening Method for Microparticles in Platelet Transfusions
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[Routine screening with APTT is not indicated before surgery].

Li Bian1, Fariba Baghaei2, Jovan Antovic3

  • 1med dr, specialistläkare, klinisk kemi, Sahlgrenska universitetssjukhuset, Göteborg.

Lakartidningen
|June 17, 2022
PubMed
Summary
This summary is machine-generated.

Routine preoperative activated partial thromboplastin time (APTT) screening is not recommended for patients without a bleeding history. This approach improves cost-effectiveness and avoids unnecessary testing for perioperative bleeding risk assessment.

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Area of Science:

  • Medical Diagnostics
  • Hematology
  • Surgical Pre-screening

Background:

  • Activated partial thromboplastin time (APTT) is a common preoperative screening test.
  • Its efficacy in predicting perioperative bleeding risk in Sweden is not well-established.
  • Current practices may not be cost-effective or clinically justified for all patients.

Purpose of the Study:

  • To review existing literature on the utility of unselected APTT testing for predicting perioperative bleeding.
  • To determine if routine APTT screening is a valuable component of preoperative assessment.
  • To provide evidence-based recommendations for APTT use in surgical patients.

Main Methods:

  • A comprehensive literature review was conducted.
  • The review focused on studies assessing the predictive value of APTT for perioperative bleeding.
  • Evidence was synthesized to evaluate the sensitivity and clinical utility of routine APTT screening.

Main Results:

  • The current literature does not support routine APTT screening for all surgical patients.
  • APTT demonstrates low sensitivity in detecting clinically significant bleeding disorders.
  • A thorough bleeding history is a more reliable indicator of bleeding risk.

Conclusions:

  • Routine preoperative APTT testing is not recommended for patients with no history of bleeding tendencies.
  • APTT should be reserved for patients with a known predisposition to bleeding.
  • Implementing this change can lead to a more cost-effective perioperative care pathway.