The role of <scp>PFA</scp>‐100 measurement in preoperative screening in total knee arthroplasty patients with perioperative replacement of cyclooxygenase‐2 inhibitor

Kim, J.; Kim, Y.; Kwon, Gye Cheol; Koo, Sun Hoe

doi:10.1111/ijlh.12276

Cited by 1 publication

(1 citation statement)

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“…Therefore, it is even more controversial to use PFA-100/200 as a preoperative screening tool for all unselected surgical patients to identify platelet disorders in Korea, where the prevalence of platelet disease is very low. This is consistent with the results of studies reported in Korea that preoperative PFA-100 screening test is less relevant to actual bleeding outcomes [20][21][22]. However, these studies had limitations to evaluate the role of PFA as a preoperative screening tool in unselected patients because the number of included patients was small and only specific operations were included.…”

Section: Discussionsupporting

confidence: 86%

The role of platelet function analyzer-200 in predicting perioperative bleeding risk

Jeon

Kang

et al. 2020

Korean J Intern Med

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Background/Aims: Various preoperative screening tests, such as platelet count, prothrombin time, activated partial thromboplastin time, and bleeding time, have been widely used to evaluate the risk of bleeding during surgery. Use of platelet function analyzer (PFA)-100/200 for assessing platelet function instead of bleeding time is increasing. However, its role in predicting the perioperative risk of bleeding remains controversial. Methods: Data of 703 patients who underwent surgery under general anesthesia were retrospectively analyzed. Preoperative platelet function was measured using PFA-200 system and the association with intraoperative bleeding was assessed. Additionally, other variables that could affect PFA-200 results were assessed by logistic regression analysis. Results: Collagen/epinephrine (COL/EPI) test was prolonged in 199/703 (28.3%) patients (EPI group), while 99/212 (46.7%) patients showed COL/adenosine diphosphate test abnormalities. Bleeding over 300 mL during surgery occurred in 14.3% and 20.1% of patients in the normal and EPI groups, respectively (p = 0.058). In addition, red blood cell transfusion within 72 hours after surgery rate was significantly higher in the EPI group than in the normal group (31.7% vs. 23.4%, p = 0.024). In multivariate logistic analysis, prolongation closure time with COL/EPI (p = 0.068) was marginally associated with risk of bleeding during surgery. Furthermore, PFA-200 results were influenced by various factors, such as nonsteroidal anti-inflammatory drug use, blood group, hematocrit, and time of blood collection. Conclusions: Preoperative PFA-200 test may be helpful in predicting the risk of perioperative bleeding. However, its results should be carefully interpreted because they are affected by several factors.

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Section: Discussionsupporting

confidence: 86%