Utility of preoperative in vitro platelet function tests for predicting bleeding risk in patients undergoing functional endoscopic sinus surgery

Lee, A-Jin; Kim, Sang-Gyung

doi:10.2147/jbm.s117669

Cited by 5 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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 - 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: 92%

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

Jeon

Kang

et al. 2020

Korean J Intern Med

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 92%

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

Jeon

Kang

et al. 2020

Korean J Intern Med

View full text Add to dashboard Cite

show abstract

“…Coagulation function tests have been found to be useful indicators for the prediction of thrombus formation and heat stroke prognosis ( 27 , 28 ). However, a study involving 88 adult CRS patients who underwent FESS revealed that preoperative coagulation screening tests such as PT, international normalized ratio (INR), and APTT were not effective in predicting intraoperative bleeding ( 29 ). Nevertheless, other studies have indicated that the use of anticoagulants, either locally or systemically, can help to reduce bleeding associated with FESS ( 30–32 ).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting poor operative visibility during FESS in Chinese adult patients with CRS

Sun,

Liang,

Yang

et al. 2024

Front. Med.

View full text Add to dashboard Cite

ObjectiveThe purpose of this study is to develop and evaluate a nomogram that is capable of predicting poor operative visibility during functional endoscopic sinus surgery.MethodTo identify potential risk factors, patients with chronic rhinosinusitis who underwent functional endoscopic sinus surgery (FESS) between January 2019 and December 2022 were selected from our hospital’s electronic medical record system. Data on general patient information, clinical manifestations, clotting-related test indices, Lund-Machay score of sinuses CT scanning, Lund-kennedy score of nasal endoscopies, anesthesia methods, intraoperative blood pressure and heart rate, and Boezaart bleeding score were collected. Minimum absolute convergence and selection operator (LASSO) regression, as well as multivariate logistic regression, were used to determine the risk factors. A nomogram was developed in order to predict poor operating visibility during FESS, and its performance was evaluated utilizing both the training and verification datasets via various measures including receiver operating characteristic (ROC) curve analysis, area under the curve (AUC), Hosmer-Lemeshow goodness-of-fit test, calibration curve, and decision curve analysis.ResultsOf the 369 patients who met the inclusion criteria, 88 of them exhibited POV during FESS. By deploying LASSO and multivariate logistic regression analyses, six risk factors were identified and used to construct a nomogram for predicting POV during FESS. These factors include prothrombin time (PT), prothrombin activity (PTA), Lund-Mackay score (LMS), Lund-Kennedy score (LKS), anesthetic method, and intraoperative hypertension. The AUC of the training set was found to be 0.820 while that of the verification set was 0.852. The Hosmer-Lemeshow goodness-of-fit test and calibration curve analysis revealed good consistency between predicted and actual probabilities. Also, the decision curve demonstrated that the nomogram had a high degree of clinical usefulness and net benefit.ConclusionThe constructed nomogram has a strong ability to predict the poor intraoperative field in patients with chronic rhinosinusitis, which can help preoperative judgment of high-risk patients and provide evidence for perioperative management and preoperative plan formulation.

show abstract

“…Other Korean studies on the usefulness of PFA before surgery reported similar results. Lee and Kim [ 12 ] did not confirm the usefulness of PFA in endoscopic sinus surgery and concluded that the routine use of PFA is not recommended in endoscopic sinus surgery. Jeon et al [ 13 ] reported that PFA abnormalities in total knee arthroplasty were not related to postoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Gwon

Kim

2022

Ann Surg Treat Res

View full text Add to dashboard Cite

Purpose The platelet function analyzer (PFA)-100/200 is widely used to assess platelet function. However, its role in predicting the perioperative risk of bleeding in patients undergoing liver resection remains controversial. Therefore, we aimed to ascertain whether the platelet function test could be useful in predicting bleeding risk in patients undergoing hepatic surgery. Methods The study participants were patients who underwent hepatectomy for hepatocellular carcinoma at our hospital over a period of 10 years from January 1, 2010 to May 31, 2020. PFA-200 values of these patients were divided into 2 groups; normal (n = 333) and prolonged (n = 39). Results There were no significant differences regarding the volumes of calculated blood loss during surgery between the normal and prolonged PFA groups (879.55 ± 1,046.50 mL vs. 819.74 ± 912.64 mL, respectively; P = 0.733); intraoperative RBC transfusion (0.52 ± 2.02 units vs. 0.26 ± 1.02 units, P = 0.419) and postoperative RBC transfusion (0.24 ± 1.17 units vs. 0.46 ± 1.97 units, P = 0.306) were similar between the 2 groups, respectively. Multivariate analysis revealed no association between PFA closure time and calculated blood loss (hazard ratio, 1.06; P = 0.881). Moreover, there was no association between PFA closure time and preoperative laboratory results or assessment of tool-related liver function in multivariate analysis. Conclusion There was no correlation between the amount of blood loss and platelet function in patients who underwent liver resection. In patients undergoing liver resection who are not managed on antiplatelet agents or do not have chronic kidney disease, the use of routine PFA is not recommended.

show abstract

Utility of preoperative in vitro platelet function tests for predicting bleeding risk in patients undergoing functional endoscopic sinus surgery

Cited by 5 publications

References 22 publications

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

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

Development and validation of a nomogram for predicting poor operative visibility during FESS in Chinese adult patients with CRS

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Contact Info

Product

Resources

About