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

Eun Sang Yu, Min Ji Jeon, Ka Won Kang, Byung Hyun Lee, Eun Joo Kang, Yong Park, Se Ryeon Lee, Hwa Jung Sung, Chul Won Choi, Byung Soo Kim, Dae Sik Kim

    Research output: Contribution to journalArticlepeer-review

    1 Citation (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)1199-1209
    Number of pages11
    JournalKorean Journal of Internal Medicine
    Volume35
    Issue number5
    DOIs
    Publication statusPublished - 2020

    Keywords

    • Bleeding
    • Platelet function analyzer
    • Screening test
    • Surgery

    ASJC Scopus subject areas

    • Internal Medicine

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