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Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time preoperative study

International Journal of Otolaryngology and Head & Neck Surgery 2015年第3期4卷 241-247页

作者： Noemi Aguirre Francisca Cordova Francisca Jaime Ximena Fonseca Pamela Zúniga Pediatrics Resident Pontifical Catholic University of ChileSantiagoChile School of Medicine Pontifical Catholic University of ChileSantiagoChile Pediatrician Resident of Pediatric Gastroenterology and NutritionPontifical Catholic University of ChileSantiagoChile Otorhinolaryngologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile Hematologist-Oncologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile

Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology.

关键词： aPTT preoperative study Tonsillectomy Adenoidectomy Coagulopathy

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