The Role Of Coagulation Testing Prior To Surgery

Abstract

Preoperative  coagulation  screening  has  been  among  the  most  debated  of  all  laboratory  tests, especially  in  children. Although  an undiagnosed  coagulopathy  could result in  serious surgical  morbidity, commonly used screening tests such  as bleeding  time, prothrombin  time,  activated partial  thromboplastin time, and platelet count, do not reliably predict abnormal  perioperative bleeding. Laboratory testing should be considered in  patients either  the history  or  medical  condition  suggests a  possible  hemostatic defect,  in patients undergoing surgical  procedures that might induce  hemostatic disturbances (eg, cardiopulmonary bypass),  when  the  coagulation  system  is particularly  needed  for  adequate  hemostasis (eg, tonsillectomy), and in patients for  whom even minimal postoperative  bleeding could be critical  (eg, neurosurgery). In  the case of minor surgery and a negative history of clotting disorders, no tests are suggested.