ABSTRACT
Objetivo: determinar si existe asociación entre pruebas de coagulación prequirúrgicas (PCP) anormales y el desarrollo de hemorragia transquirúrgica (HTQ), en cirugía electiva. Material y métodos: durante el año 2002 se seleccionaron en forma no probabilística a pacientes > 18 años intervenidos quirúrgicamente en un hospital de tercer nivel de atención médica en Mérida, Yucatán en los que se buscó HTQ. Ésta se dio cuando la hemorragia en el lecho quirúrgico fue > 300 ml. Las PCP medidas fueron el tiempo de protrombina (TP) y el tiempo de tromboplastina parcial (TTP). Los datos se analizaron con estadística inferencial. Resultados: TP o TTP fue solicitado a 100% de los pacientes; el primero estuvo prolongado en 26 (15%) y el segundo en 14 (8%). Los eventos hemorrágicos se documentaron en 30 casos (18%). Entre aquellos con o sin hemorragia, los valores promedio del TP o del TTP no fueron significativamente diferentes (P= 0.76 y P= 0.83, respectivamente). Asimismo, las PCP anormales, tampoco se asociaron significativamente con la presencia de HTQ (Prueba exacta de Fisher con P> 0.05 para cada una). Conclusión: en este grupo de pacientes las PCP anormales, no se asociaron con HTQ.
Main objective: To determine whether abnormal preoperative coagulation tests (PCT) are relatedto trans-surgical bleeding complication (TSBC) during elective surgical procedures. Material and methods. Adult patients, undergone some elective surgical procedure in a tertiary care medical center, in Merida, Yucatan, Mexico in whom TSBC was looked for, were selected in a non-random fashion and included. TSBC was considered when bleeding in the surgical bed was >300 ml. Prothrombin time (PT) and partial thromboplastin time (PTT) were the PCT measured and compared against TSBC. To analyze data, inferential statistics was used. Results: Eighty four males (49%) and 86 females (51%), were included. PT, PTT or both were requested to 100% of the them. PT was prolonged in 26 (15%), and PTT was prolonged in 14 (8%) patients. TSBC was documented in 30 patients (18%), although among those with and without bleeding, neither PT averages difference (P=0.76), nor PTT averages difference (P=0.83), were statistically significant. In comparing TSBC and its relationship to abnormal PCT, again neither PT nor PTT were associated with bleeding (Fisher's exact tests for each: P= 0.41 and P= 1.0, respectively). Conclusion: In this sample, abnormal PCT were not associated with TSBC.