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Clinical Challenges
May 2000

Preoperative Coagulation Studies Prior to Tonsillectomy

Author Affiliations

H. CALHOUNKARENMDB. KUPPERSMITHRONALDMDFrom the Department of Otolaryngology, Albert Einstein College of Medicine of Yeshiva University, Montefiore Medical Center, New York, NY (Drs Hartnick and Ruben); and Department of Pediatric Otolaryngology, Children's Hospital Medical Center, Cincinnati, Ohio (Dr Hartnick).

Arch Otolaryngol Head Neck Surg. 2000;126(5):684-686. doi:10.1001/archotol.126.5.684

The safest workup for a pediatric tonsillectomy includes determination of hematocrit and platelet levels. Unless family history or personal history is suggestive, no other laboratory tests are required.

Striving toward cost-effective medicine while maintaining appropriate standards, the health care profession is calling into question traditional practices and procedures. Each laboratory test or radiographic study is examined in light of its potential efficacy. Statistical data are analyzed to justify such tests if they are being used on a routine basis. One issue that is hotly debated is the preoperative evaluation prior to tonsillectomy in the pediatric population. The stakes are high: approximately 300,000 tonsillectomies/adenoidectomies are performed annually.1 Although mortality statistics have decreased in the contemporary era of medicine, the morbidity rate remains clinically significant, with the incidence of postoperative bleeding ranging from 2% to 7%.2

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