166 - Haemostatic assessment of the preoperative risk of bleeding. Comparison of the guidelines of NICE and of the Italian Society for Throm- bosis and Haemostasis (SISET: Società Italiana per ...

Autor(s): B. Cosmi, A. Alatri, M.Cattaneo, P. Gresele, M. Marietta, F. Rodeghiero, A. Tripodi, L. Ansaloni, M. Fusari, S. Taddei

Issue: RIMeL - IJLaM, Vol. 5, N. 2, 2009 (MAF Servizi srl ed.)

Page(s): 166-167

The Italian Society for Thrombosis and Haemostasis (SISET: Società Italiana per lo Studio dell’Emostasi e Trombosi) promoted the development of a series of guidelines which would adopt evidence-based medicine methodology on clinically relevant problems in the field of haemostasis and thrombosis1. The objective of the present guidelines is to provide recommendations for the pre-operative and pre-procedural assessment of the bleeding risk with the aim of reducing the incidence of preventable bleeding complications and limiting laboratory tests to the bare necessary. The risk of bleeding is usually assessed by eliciting the personal and family history for abnormal bleedings, and performing laboratory tests that explore the haemostatic functions. These laboratory tests generally include the prothrombin time (PT), the activated partial thromboplastin time (APTT), the platelet count, the bleeding time and, more rarely, PFA-100 closure time, thromboelastography and platelet aggregation tests. However, the choice and interpretation of these tests and the clinical management of patients with abnormal results is highly variable. The appropriate choice of laboratory tests requires an accurate assessment of the clinical situation, the evaluation of the prevalence of bleeding disorders, the test characteristics, the cost and the consequences of false-positive and false-negative results. ...

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