Abstract

COPANA OLMOS, Raúl; PERALTA CABALLERO, Mauricio; UNZUETA QUIROGA, Roberto  and  CARPIO DEHEZA, Gonzalo. Usefulness of prothrombin and activated partial thromboplastin time in the preoperative assessment of hemostasis in pediatrics . Gac Med Bol [online]. 2020, vol.43, n.2, pp.137-142. ISSN 1012-2966.

To evaluate hemostasis preoperatively, a directed clinical history and physical examination are indicated, and the use of routine coagulation being recommended when there is some indication, and not routine;  Objective: the present study aims to know the usefulness of PT and APTT in the preoperative assessment of coagulopathies in scheduled minor and outpatient surgeries. Methods: A prospective, observational study was conducted in a tertiary surgical hospital; We select patients undergoing minor and outpatient procedures, excluding those with comorbidities, surgical risk of high bleeding, or with medication that interferes with coagulation. Results: 69 patients were recruited, the clinical history and the directed physical examination were applied, identifying 1 patient suspected of coagulation disorder (later discarded); 218 complementary tests were performed: 69 routine (PT, APTT, blood count) and 149 non-routine (arbitrarily indicated), obtaining mean values in normal ranges and not being able to identify or rule out coagulation disorders with them, but observing 21% ( 15 cases) abnormal results (false positives), which additionally led to behaviors to confirm or correct these values, ranging from repeating the test to transfusing blood products; generating a global average cost of 102 Bs. per patient, without a benefit or change in clinical or surgical behavior. Conclusion: the study established that routine preoperative screening tests have little utility and are little cost-beneficial in the assessment of the hemostasis for minor or outpatient procedures, compared to a history and directed physical examination; its indication being appropriate when there are abnormal findings in the physical examination and clinical history or based on concomitant diseases

Keywords : screening; screening; hemostasia; pediatric surgery; preoperative assesment.

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