A Practical Concept for Pre-Operative Identification and Improved Management of Patients at Risk for Bleeding

Total of 5649 unselected adult patients were enrolled to identify impaired hemostasis prior to surgical interventions. Each patient was asked to answer a standardized questionnaire of bleeding history. Activated partial thromboplastin time (aPTT), prothrombin time (PT) and platelet counts (PC) including PFA-100 (platelet function analyzer): collagen-epinephrine (C/E) and collagen-ADP (C/ADP) were routinely done in all patients. Additional tests, bleeding time (BT) and von Willebrand factor (vWF: Ag) were performed only in patients with a positive bleeding history and/or evidence of impaired hemostasis, e.g. drug ingestion.