Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Sarny, S; Ossimitz, G; Habermann, W; Stammberger, H; .
Preoperative coagulation screening prior to tonsillectomy in adults: current practice and recommendations.
EUR ARCH OTO-RHINO-LARYNGOL. 2013; 270(3): 1099-1104.
Doi: 10.1007/s00405-012-2099-z
Web of Science
PubMed
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FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Sarny Stephanie
- Co-Autor*innen der Med Uni Graz
- Habermann Walter
- Stammberger Heinz
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- Abstract:
- The hypotheses of the study are: (1) a positive history of coagulopathy predicts a higher postoperative haemorrhage risk, (2) a positive laboratory screening for coagulopathy can forecast a higher haemorrhage risk and (3) the haemorrhage risk in patients with known bleeding disorder is elevated. In a multicentre study information on 3,041 tonsillectomies in adults over 9 months, from 1st October 2009 until 30th June 2010, was evaluated. The outcome variables were patient characteristics, postoperative haemorrhage, history of coagulopathy and laboratory screening for coagulopathy. A history of coagulopathy and laboratory screening for coagulopathy were performed in almost all patients (98.6 %, 2,998/3,041). The overall haemorrhage rate was 16 %, including all bleeding episodes after extubation, with 4.8 % returning to theatre. A positive history was reported in 2 % (55/3,041) and a positive laboratory screening in 3 % (94/3,041) of all patients. A positive history is significantly associated with a higher risk of postoperative haemorrhage (31 %, 17/55, p < 0.002) compared to patients with a negative history (16 %, 387/2,497). A positive laboratory for coagulopathy was not significantly associated with an increased haemorrhage risk (20 %, 19/94, p < 0.235) compared to patients with a negative laboratory (16 %, 390/2,249). The haemorrhage risk for adults with a bleeding disorder is twice as high (31 %, 17/55) as for adults without bleeding disorder (16 %, 476/2,973). In conclusion, an adult patient's history of coagulopathy should be taken prior to tonsillectomy as a positive history doubles the haemorrhage risk while a laboratory screening for coagulopathy has no significant power to predict an elevated haemorrhage risk. Bleeding disorders double the risk of postoperative haemorrhage.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Blood Coagulation Disorders - diagnosis
- Blood Coagulation Tests - utilization
- Female -
- Humans -
- Male -
- Postoperative Hemorrhage - prevention & control
- Practice Guidelines as Topic -
- Preoperative Care - methods
- Prospective Studies -
- Risk Factors -
- Tonsillectomy - methods
- Tonsillitis - surgery
- Young Adult -
- Find related publications in this database (Keywords)
- Tonsillectomy
- Haemorrhage risk
- History of coagulopathy
- Laboratory screening for coagulopathy