[An attempt to evaluate the reliability of coagulation tests in postoperative haemorrhages in patients operated for tonsil disorders].

Postoperative haemorrhage is an important complication of surgical procedures performed on adenoids and tonsils. They occur rarely but they seriously endanger the patients. Determining risk factors of the postoperative haemorrhages might be very important. The aim of the study was to analyze values of coagulation tests' results obtained in the patients prior to the operations, to determine correlation between the values of the results and incidents of postoperative haemorrhages, and to answer the question whether performing the coagulation tests in these patients is cost-effective. Records of 249 patients aged from 2 to 60 (mean 10.1) years treated in our department between January 2007 and May 2008 were analysed retrospectively. Values of activated partial thromboplastin time (APTT), prothrombin/INR ratio and platelet count were analyzed. In 50 (20.1%) individuals coagulation tests' values were elevated, among them APTT results in 48 (19.3%) patients. In 36 (14.5%) of them the results exceeded the normal range by less than 10% and in the remaining 14 (5.6%)--by 10% or more. There were 16 (6,4%) cases of postoperative haemorrhage. 11 (4.4%) of them occurred in the first 24 postoperative hours. In only 3 (1.2%) individuals (with early haemorrhages) the values were elevated, in 2 (0,8%) less than by 10%, in one (0.4%) more than by 10%. No statistically significant correlation between frequency of haemorrhages and the obtained coagulation tests results in the groups of patients was established. Blood tests' performed prior to the operations on adenoids and tonsils have no relevance for the course of the operation and postoperative bleeding event, particularly in children. Blood tests should only be performed in patients with a relevant bleeding history.