Bleeding Risk in Children with Preoperative Prolonged Coagulation Tests
Ali Ayçiçek1, Aykut Saral21University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, Clinic of Pediadric Hematology and Oncology, İstanbul, Turkey2Eskisehir State Hospital, Biochemisty Laboratory, Eskişehir, Turkey
Objective: Prolonged coagulation test is a common finding before surgery. This study determined the prolonged prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) during the surgical preparation of pediatric patients.
Material and Methods: As a cross-sectional study, 74 children aged 0.25-17 years, who had prolonged preoperative coagulation tests, were included in the Eskişehir State Hospital Pediatric Hematology and Oncology Clinic between September 3, 2013, and September 16, 2014.
Results: The mean age of the children was 5.6±3.4 years, wherein 60 (81%) cases were male. Adenoid-tonsillar operations were planned in 46%, circumcision in 43%, abdominal operations in 5%, and other operations in 6%. A history of bleeding was found in 7 (10%) of the families and 3 (4%) of the cases. Previous surgery or injury was found in 24 (32%) of the children and did not develop more bleeding than expected. The coagulation tests revealed 22 (30%) patients with prolonged PT (value range: 14-35.1 s), 47 (63%) with prolonged aPTT (value range: 37.1-129.6 s), and 5 (7%) with both prolonged PT and aPTT. A necessary operation was performed in 47 patients who did not have a history of bleeding diathesis in the patient or family, with a normal mixed test and factor levels, and PT of <20 s and aPTT of <63.3 s. No bleeding complications were observed during or after the operation in any of these cases.
Conclusion: Our results revealed that in case of prolonged PT or aPTT values before surgery, no risk of bleeding is encountered during the surgery if a history of bleeding diathesis is not present in the patient or family and factor levels are normal.
Manuscript Language: English
