THE IMPORTANCE OF PREOPERATIVE ANALYSIS O F COAGULATION FOR THE ASSESSMENT OF THE RISK OF POSTOPERATIVE BLEEDING IN GENERAL-SURGERY

Coagulation studies, i.e. platelet count, prothrombin time (PT) and ac tivated partial thrombin time (aPTT) are commonly employed preoperativ ely to identify patients at risk. In a retrospective study we evaluate d the usefulness of these screening tests to predict postoperative ble eding in 1447 patients with abdominal and thoracic surgery Forty-six p atients (3.2%) experienced postsurgical bleeding. 12.2% of our patient s had abnormal coagulation studies, The sensitivity of abnormal coagul ation studies with respect to postoperative bleeding was 23.9%. The se nsitivity of the parameter ''patient at risk'', i.e. patients with sus pected coagulopathies due to drugs or disease of the liver or kidney, was 56.5%. Thirty-four out of 1008 patients without risk factors had a bnormal coagulation tests but an uneventful postoperative course. Preo perative screening of PT and aPTT should be reserved for patients with known or suspected inherited or acquired coagulopathies.