Published April 2017
A Cincinnati Children’s research team has identified a more cost-effective assessment tool for determining which patients face elevated risk of blood loss when undergoing major spinal surgery.
The tool was developed by a multidisciplinary team led by first author Jennifer Anadio, a clinical research manager in the Division of Orthopaedics; Peter Sturm, MD, director of the Crawford Spine Center; and senior author Joseph Palumbo, MD, of the Cancer and Blood Diseases Institute.
“This study indicates that a history-based bleeding assessment tool can be used to better predict which pediatric patients require a more detailed preoperative hemostatic system assessment, as well as which patients require no preoperative labs whatsoever,” Palumbo says. “This will both decrease costs and improve care, as it can identify patients at a higher risk for bleeding.”
Many pediatric surgeons rely on an unfocused history and measurement of general markers of hemostasis for preoperative screening. Better preoperative screening, the research team reports, includes using a detailed questionnaire based on the International Society of Thrombosis and Hemostasis Bleeding Assessment Tool (BAT), in combination with evaluation of medical tests that characterize blood clotting and platelet count and function.