differences in trauma center levels colorado

DIFFERENCES IN TRAUMA CENTER LEVELS COLORADO SERIES

334/364 (91.8%) patients had labs drawn in the ED. Operative control of bleed was performed in 68/364 (18.7%) patients. Average age at surgery was 8.12 years (SD = 4.0) and average post-operative day at presentation was 6 days (SD = 2.1). Lab work included complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), and von Willebrand factor (VWF).ģ64/723 (50.3%) patients met inclusion criteria. Exclusion criteria were the following: no tonsillar bleed, history of known coagulopathy, treated by outside provider, ≥18 years old. This study aims to determine the frequency and type of labs drawn at emergency department (ED) presentation and assess the incidence of uncovering a previously unidentified coagulopathy.Ī retrospective chart review was performed on pediatric patients who were seen in the ED after tonsillectomy at a tertiary care children's hospital from 2017 to 2019. Utility of lab work at presentation for PTH was low. Post-tonsillectomy hemorrhage (PTH) is a serious complication after a tonsillectomy. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective.

DIFFERENCES IN TRAUMA CENTER LEVELS COLORADO SERIES

Also no patients were identified in this series to have previously undiagnosed coagulopathies on the basis of screening PT/PTT. For patients with no history or clinical signs indicating possible bleeding disorder, preoperative PT and PTT failed to predict bleeding as an outcome. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. Preoperative coagulation studies are commonly employed in order to try to identify the 2–4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications.

Differences in trauma center levels colorado