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Platelet function testing in patients with post-operative tonsillectomy bleeding may be a useful early identifier of inherited platelet function disorders

Published online by Cambridge University Press:  05 October 2020

T W James ,
B J Thomson ,
D N Naumann  and
D S Stevenson
T W James*
Affiliation:
Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, UK
B J Thomson
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Christchurch Hospital, New Zealand
D N Naumann
Affiliation:
Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, UK
D S Stevenson
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Christchurch Hospital, New Zealand
*
Author for correspondence: Mr Tobias W James, Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, UK E-mail: tobias.james@nhs.net
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Abstract

Background

Post-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before.

Objectives

To assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients.

Methods

An observational cohort study was conducted using hospital digital records. Platelet function analyser 100 (‘PFA-100’) closure time was tested on post-tonsillectomy bleed patients who presented to hospital.

Results

Between 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent.

Conclusion

The prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.

Keywords

TonsillectomyBlood Platelet DisordersPlatelet Function TestsVon Willebrand Disease
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 10 , October 2020 , pp. 882 - 886
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Mr T W James takes responsibility for the integrity of the content of the paper

Presented at the New Zealand Society of Otolaryngology, Head and Neck Surgery Annual Scientific Meeting, 19 October 2018, Queenstown, New Zealand.

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