Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics
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| Format: | Artículo científico |
| Langue: | en |
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Universidad Mayor de San Simón
2020
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| _version_ | 1876462882776940544 |
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| author | Raúl Copana Olmos |
| author_facet | Raúl Copana Olmos |
| contents | Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics Raúl Copana Olmos Mauricio Peralta Caballero Roberto Unzueta Quiroga Gonzalo Carpio Deheza Medicina Screening hemostasia pediatric surgery preoperative assesment In order to evaluate hemostasis preoperatively, clinical history and physical examination are required, and the use of coagulation tests is recommended only when there is an indication, and not as a routine procedure. Objetive: the present study aims to determine the usefulness of TP and APTT in the preoperative assessment of coagulopathies in scheduled minor and outpatient surgeries. Methods: we conducted a prospective, observational study in a tertiary surgical hospital; we selected patients undergoing minor and ambulatory procedures, excluding those with comorbidities, high surgical bleeding risk or with medication that interferes with coagulation. Results: 69 patients were recruited, clinical history and directed physical examination were applied identifying 1 patient suspected of coagulation disorder (later discarded); 218 complementary examinations were performed: 69 routine (TP, APTT, hemogram) 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, which additionally caused behaviors to confirm or correct these values, ranging from repeating the test to transfusing hemoderivatives; generating an overall average cost of 102 Bs. 102 Bs. per patient, without benefit or change in clinical or surgical conduct. Conclusion: the study established that routine preoperative screening tests are of little use and are not very cost-effective in the evaluation of hemostasis for minor or ambulatory procedures, compared to a clinical history and directed physical examination; their indication is appropriate when there are abnormal findings in the physical examination and clinical history or based on concomitant diseases. 2020 artículo científico 1012-2966 https://www.redalyc.org/articulo.oa?id=445674705012 https://www.redalyc.org/journal/4456/445674705012/ https://www.redalyc.org/journal/4456/445674705012/html/ https://www.redalyc.org/journal/4456/445674705012/445674705012.epub https://www.redalyc.org/journal/4456/445674705012/movil en http://www.redalyc.org/revista.oa?id=4456 Gaceta Médica Boliviana application/pdf Universidad Mayor de San Simón Gaceta Médica Boliviana (Estado Plurinacional de Bolivia) Num.2 Vol.43 |
| format | Artículo científico |
| id | redalyc_445674705012 |
| institution | Redalyc |
| language | en |
| publishDate | 2020 |
| publisher | Universidad Mayor de San Simón |
| spellingShingle | Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics Raúl Copana Olmos Medicina Screening hemostasia pediatric surgery preoperative assesment Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics Raúl Copana Olmos Mauricio Peralta Caballero Roberto Unzueta Quiroga Gonzalo Carpio Deheza Medicina Screening hemostasia pediatric surgery preoperative assesment In order to evaluate hemostasis preoperatively, clinical history and physical examination are required, and the use of coagulation tests is recommended only when there is an indication, and not as a routine procedure. Objetive: the present study aims to determine the usefulness of TP and APTT in the preoperative assessment of coagulopathies in scheduled minor and outpatient surgeries. Methods: we conducted a prospective, observational study in a tertiary surgical hospital; we selected patients undergoing minor and ambulatory procedures, excluding those with comorbidities, high surgical bleeding risk or with medication that interferes with coagulation. Results: 69 patients were recruited, clinical history and directed physical examination were applied identifying 1 patient suspected of coagulation disorder (later discarded); 218 complementary examinations were performed: 69 routine (TP, APTT, hemogram) 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, which additionally caused behaviors to confirm or correct these values, ranging from repeating the test to transfusing hemoderivatives; generating an overall average cost of 102 Bs. 102 Bs. per patient, without benefit or change in clinical or surgical conduct. Conclusion: the study established that routine preoperative screening tests are of little use and are not very cost-effective in the evaluation of hemostasis for minor or ambulatory procedures, compared to a clinical history and directed physical examination; their indication is appropriate when there are abnormal findings in the physical examination and clinical history or based on concomitant diseases. 2020 artículo científico 1012-2966 https://www.redalyc.org/articulo.oa?id=445674705012 https://www.redalyc.org/journal/4456/445674705012/ https://www.redalyc.org/journal/4456/445674705012/html/ https://www.redalyc.org/journal/4456/445674705012/445674705012.epub https://www.redalyc.org/journal/4456/445674705012/movil en http://www.redalyc.org/revista.oa?id=4456 Gaceta Médica Boliviana application/pdf Universidad Mayor de San Simón Gaceta Médica Boliviana (Estado Plurinacional de Bolivia) Num.2 Vol.43 |
| title | Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics |
| topic | Medicina Screening hemostasia pediatric surgery preoperative assesment |
| url | https://www.redalyc.org/articulo.oa?id=445674705012 https://www.redalyc.org/journal/4456/445674705012/ https://www.redalyc.org/journal/4456/445674705012/html/ https://www.redalyc.org/journal/4456/445674705012/445674705012.epub https://www.redalyc.org/journal/4456/445674705012/movil |