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QQ: Pre-op Screens

A summary of our May, 2013 Quick Question with 57 respondents:

Surgeons typically order pre-operative hemostasis screens. What assays are included in your pre-operative screen?

a. PLT count, PT, PTT: 40 (69%)
b. None, we don’t perform pre-op screen: 8 (14%)
c. PLT count, PT, PTT, TT, fibrinogen: 5 (9%)
d. PLT count, PT, PTT, BT: 3 (5%)
e. PLT count, PT, PTT, TT: 1 (3%)

It looks like most of us are doing standard pre-operative screens, though we know, of course, the PT and PTT generally fail to predict intraoperative bleeding when applied as screens of an unselected population. I’d like to know how the eight enlightened organizations are able to convince their surgeons that a history is more predictive than the tests. Also, the apparent general decline of the bleeding time is a positive development.

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