Protocollo per l’identificazione di pazienti con difetti congeniti dell’emostasi non noti: screening pre-operatorio

Congenital Hemorrhagic Diseases (CHD) are often complicated by intra- and post-surgical bleeding that is the cause of diagnostic procedures. This study presents a protocol applied to the patients with indication of elective surgery, aimed to detected CHD and the consequent surgical hemorrhagic risk, on the basis of structured history concerning bleeding tendency (Bleeding Score-BS) and/or laboratory clotting screening tests. 1100 consecutive patients have been enrolled. The abnormal BS and/or alterations of screening clotting tests, have been further evaluate by medical staff experienced on hemostasis to make the diagnosis of CHD and to suggest hemostatic prophylaxis during and after surgery. In conclusion these preliminary data do not support the hypothesis that mild CHD are under diagnosed in general populations. A case-control study will be planned to register eventual differences on bleeding surgical complications between patients considered as care or as control in our protocol.