Dataset Information

Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice.

ABSTRACT:

Background

Patients with mild bleeding disorders are at risk of perioperative bleeding, but screening for these disorders remains challenging.

Objectives

We aimed to assess the prevalence of hemostatic abnormalities in patients with and without reported bleeding symptoms on a preoperative questionnaire, consisting of guideline-proposed questions, and appraised the diagnostic value of several screening modalities for the identification of patients with hemostatic abnormalities.

Methods

In this observational study, 240 patients with and 95 patients without bleeding symptoms on the preoperative questionnaire were included. Patients with known bleeding disorders, antithrombotic drugs, thrombocytopenia, and anemia were excluded. Preoperatively, all patients underwent elaborate hemostatic testing. Hemostatic abnormalities were defined as coagulation, vWF, or fibrinolysis factor levels below reference range and platelet function defects. Screening modalities included the ISTH Bleeding Assessment Tool (ISTH-BAT), PT, aPTT, TT, Euglobulin Lysis Time (ELT), and Platelet Function Analyser (PFA).

Results

In 21 of 240 (8.8%) patients reporting bleeding symptoms, hemostatic abnormalities were found, including 7 reduced coagulation factor levels, 10 platelet function abnormalities, and 4 reduced vWF levels. In comparison, 10 of 95 (10.5%) patients not reporting bleeding symptoms had abnormalities. The ISTH-BAT could not identify patients with abnormalities, while PT, aPTT, TT, ELT, and PFA had high specificity but low sensitivity to detect abnormalities.

Conclusions

The prevalence of hemostatic abnormalities in both patients with and without reported bleeding symptoms was 9%-10%. This suggests that the guideline-based questionnaire cannot differentiate between patients with and without abnormalities, while the discriminative power of the screening modalities is also limited.

SUBMITTER: Vries MJ

PROVIDER: S-EPMC6178633 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice.

Vries Minka J MJ van der Meijden Paola E PE Kuiper Gerhardus J GJ Nelemans Patricia J PJ Wetzels Rick J RJ van Oerle René G RG Lancé Marcus D MD Ten Cate Hugo H Henskens Yvonne M YM

Research and practice in thrombosis and haemostasis 20180727 4

<h4>Background</h4>Patients with mild bleeding disorders are at risk of perioperative bleeding, but screening for these disorders remains challenging.<h4>Objectives</h4>We aimed to assess the prevalence of hemostatic abnormalities in patients with and without reported bleeding symptoms on a preoperative questionnaire, consisting of guideline-proposed questions, and appraised the diagnostic value of several screening modalities for the identification of patients with hemostatic abnormalities.<h4> ...[more]

PMID: 30349896

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Dataset Information

Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice.

Background

Objectives

Methods

Results

Conclusions

Publications

Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice.

Similar Datasets

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