Use and utility of preoperative hemostatic screening and patient history in adult neurosurgical patients

Journal of Neurosurgery
Andreea SeiceanRobert J Weil

Abstract

The utility of preoperative hemostasis screening to predict complications is uncertain. The authors quantified the screening rate in US neurosurgery patients and evaluated the ability of abnormal test results as compared with history-based risk factors to predict hemostasis-related and general outcomes. Eleven thousand eight hundred four adult neurosurgery patients were identified in the 2006-2009 American College of Surgeons National Surgical Quality Improvement Program database. Multivariate logistic regression modeled the ability of hemostatic tests and patient history to predict outcomes, that is, intra- and postoperative red blood cell [RBC] transfusion, return to the operating room [OR], and 30-day mortality. Sensitivity analyses were conducted using patient subgroups by procedure. Most patients underwent all 3 hemostatic tests (platelet count, prothrombin time/international normalized ratio [INR], activated partial thromboplastin time), but few had any of the outcomes of interest. The number of screening tests undergone was significantly associated with intraoperative RBC transfusion, a return to the OR, and mortality; an abnormal INR was associated with postoperative RBC transfusion. However, all tests had low sensitivi...Continue Reading

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Citations

Dec 14, 2012·Current Opinion in Anaesthesiology·Hans Gombotz, Hans Knotzer
Jun 4, 2015·Journal of Thrombosis and Thrombolysis·Hani TamimAli Taher
Sep 20, 2015·Der Internist·M Hübler, A Hübler
Dec 10, 2013·The Spine Journal : Official Journal of the North American Spine Society·Christina L GoldsteinR John Hurlbert
Jun 18, 2016·World Neurosurgery·Alexandra M G LarsenTimothy R Smith
Aug 21, 2016·The Medical Clinics of North America·Matthew H Rusk
Jun 25, 2017·World Neurosurgery·Daphne LiG Alexander Jones
Apr 13, 2019·Journal of Neurosurgery. Pediatrics·Hormuzdiyar H DasenbrockShenandoah Robinson
Aug 2, 2013·Anesthesiology·Laurent G GlanceAndrew W Dick
Aug 11, 2020·Stroke; a Journal of Cerebral Circulation·Matthew B MaasEric M Liotta
Nov 30, 2020·CNS Neuroscience & Therapeutics·Fengping ZhuYirui Sun
Jul 11, 2014·Deutsches Ärzteblatt International·Andreas B BöhmerBernd Zwissler
Feb 8, 2020·The American Journal of Emergency Medicine·Brit LongAlex Koyfman

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS

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