The Benefit for Preoperative Coagulation Screening Test in Children

Abstract

Background: We evaluated the value of preoperative screening for coagulopathy in children who have undergone elective surgery.

Methods: We retrospectively evaluated laboratory and bleeding histories in 39,884 patients aged greater than 1 year and lesser than 19 years who had undergone elective surgery from January 2003 to March 2015. All of the patients had preoperative coagulation screening with complete blood count, prothrombin time (PT) and activated partial thromboplastin time (aPTT). If PT and/or aPTT were abnormal, further studies, such as mixing test, coagulation factor assay, anti-phospholipid antibody studies were done.

Results: The study included 39,884 patients greater than 1 year and lesser than 19 years. Of 924 patients with prolonged PT and/or aPTT values, 63 were subsequently diagnosed with a factor deficiency.

Conclusion: Our result suggests that preoperative coagulation screening tests have benefit when there are no histories of bleeding tendencies because timely diagnosis allows for proper treatment, as some hereditary factor deficiencies may escape clinical detection in asymptomatic patients. Routine preoperative coagulation screening may serve as a useful adjunct to clinical history.