The role of platelet function analyzer-200 in predicting perioperative bleeding risk
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (29)
- Kozek-Langenecker SA, "Management of severe perioperative bleeding : guidelines from the European Society of Anaesthesiology", Eur J Anaesthesiol, 30, pp.270~382 (2013)
- Chee YL, "Guidelines on the assessment of bleeding risk prior to surgery or invasive procedures. British Committee for Standards in Haematology", Br J Haematol, 140, pp.496~504 (2008)
- Rodgers RP, "A critical reappraisal of the bleeding time", Semin Thromb Hemost, 16, pp.1~20 (1990)
- Harrison P, "Progress in the assessment of platelet function", Br J Haematol, 111, pp.733~744 (2000)
- Favaloro EJ, "Utility of the PFA-100 for assessing bleeding disorders and monitoring therapy : a review of analytical variables, benefits and limitations", Haemophilia, 7, pp.170~179 (2001)
- Harrison P, "The role of PFA-100 testing in the investigation and management of haemostatic defects in children and adults", Br J Haematol, 130, pp.3~10 (2005)
- Hayward CP, "Platelet function analyzer (PFA)-100 closure time in the evaluation of platelet disorders and platelet function", J Thromb Haemost, 4, pp.312~319 (2006)
- Favaloro EJ, "Clinical utility of the PFA-100", Semin Thromb Hemost, 34, pp.709~733 (2008)
- Fressinaud E, "Screening for von Willebrand disease with a new analyzer using high shear stress : a study of 60 cases", Blood, 91, pp.1325~1331 (1998)
- Mammen EF, "PFA-100 system : a new method for assessment of platelet dysfunction", Semin Thromb Hemost, 24, pp.195~202 (1998)
- Favaloro EJ, "Clinical application of the PFA-100", Curr Opin Hematol, 9, pp.407~415 (2002)
- Favaloro EJ, "Laboratory monitoring of therapy in von Willebrand disease: efficacy of the PFA-100 and von Willebrand factor:collagen-binding activity as coupled strategies", Semin Thromb Hemost, 32, pp.566~576 (2006)
- Koscielny J, "A practical concept for preoperative identification of patients with impaired primary hemostasis", Clin Appl Thromb Hemost, 10, pp.195~204 (2004)
- Fattorutto M, "Does the platelet function analyser(PFA-100)predict blood loss after cardiopulmonary bypass", Br J Anaesth, 90, pp.692~693 (2003)
- Lasne D, "A study of platelet functions with a new analyzer using high shear stress(PFA 100)in patients undergoing coronary artery bypass graft", Thromb Haemost, 84, pp.794~799 (2000)
- Cammerer U, "The predictive value of modified computerized thromboelastography and platelet function analysis for postoperative blood loss in routine cardiac surgery", Anesth Analg, 96, pp.51~57 (2003)
- 조영욱, "한국인 성인에서 Platelet Function Analyzer-100 폐색시간의분석 전 변수 확인 및 참고범위 설정", Annals of Laboratory Medicine, 27(5), pp.318~323 (2007), 대한진단검사의학회
- Poon MC, "The international, prospective Glanzmann Thrombasthenia Registry : treatment and outcomes in surgical intervention", Haematologica, 100, pp.1038~1044 (2015)
- Kundu SK, "Description of an in vitro platelet function analyzer : PFA-100", Semin Thromb Hemost 1995;21 Suppl, 21(Suppl 2), pp.106~112 (1995)
- Lee AJ, "Utility of preoperative in vitro platelet function tests for predicting bleeding risk in patients undergoing functional endoscopic sinus surgery", J Blood Med, 7, pp.235~238 (2016)
- Kim J, "The role of PFA-100 measurement in preoperative screening in total knee arthroplasty patients with perioperative replacement of cyclooxygenase-2 inhibitor", Int J Lab Hematol, 37, pp.e34~e37 (2015)
- Jeon Y, "Limitations of preoperative PFA-200 as a predictor of postoperative blood loss in total knee arthroplasty : according to use of tranexamic acid", Clin Lab, 63, pp.1121~1128 (2017)
- Cho YU, "Variables that affect platelet function analyzer-100 (PFA-100) closure times and establishment of reference intervals in Korean adults", Ann Clin Lab Sci, 38, pp.247~253 (2008)
- Dalby MC, "Diurnal variation in platelet aggregation iwth the PFA-100 platelet function analyser", Platelets, 11, pp.320~324 (2000)
- Moeller A, "Influence of ABO blood groups on primary hemostasis", Transfusion, 41, pp.56~60 (2001)
- Jafri SM, "Circadian variation in platelet function in healthy volunteers", Am J Cardiol, 69, pp.951~954 (1992)
- Tofler GH, "Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death", N Engl J Med, 316, pp.1514~1518 (1987)
- Lippi G, "Influence of the ABO blood type on the platelet function analyzer PFA-100", Thromb Haemost, 85, pp.369~370 (2001)
- Feuring M, "Impact of ABO blood groups on tirofiban mediated inhibition of platelet function", Platelets, 16, pp.430~434 (2005)