Felicia Pickard, MD, David Pace, MD. Memorial University of Newfoundland
Over the past 4 years there have been several bariatric surgeries cancelled secondarily to abnormal pre-operative test results within Eastern Health. These surgeries are often cancelled the day before their scheduled surgery, which does not provide sufficient time to book other patients. The end result is that the OR gets underutilized and the bariatric surgery waitlist grows.
Prior to any major surgery patients are often subjected to a routine screening process, which includes a history and physical along with diagnostic screening tests and screening blood work. A preliminary analysis was done of the first 50 patients through the bariatric surgery program at Eastern Health assessing the coagulation study results and outcomes.
Analysis showed that out of the first 50 patients 2% were found to have a history of bleeding, 10% were using anticoagulants preoperatively, another 2% were noted to have a family history of bleeding. In the preoperative blood work that was done, 30% were found to have an elevated PTT/INR for which hematology ended up being consulted in 4% of the patients. Overall this did not change the preoperative management of these patients and they went on to have their surgery. Intraoperatively 1 patient was noted to have excessive bleeding and this was found not be associated with any preoperative elevation in their coagulation studies or family history of bleeding disorders. Post operatively there was bleeding in 1 patient which required transfusion, however this too was found not to be associated with any preoperative elevation in their coagulation studies or family history of bleeding disorders.
Overall this initial analysis showed no difference in operative management or delay in surgery secondarily to abnormal preoperative assessment findings. Further analysis of a larger population of the bariatric surgery program patients is needed in order to determine whether any changes should be made to the preoperative assessment protocol.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88302
Program Number: P626
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster