Preoperative hematological assessment of pediatric patients

Abstract

Nutritional deficiencies and use of antiepileptic drugs can lead to alterations in the hematological status of children with cerebral palsy (CP), which may increase the risk of intraoperative or postoperative hematological complications. In this retrospective study, we evaluated the preoperative routine blood tests of CP patients with different levels of walking ability, who were scheduled to undergo orthopedic procedures. Hemoglobin level, hematocrit, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, and plasma fibrinogen concentration were compared between 62 consecutive CP patients [28 girls, 34 boys; mean age 8.8 years (range 2-16 years)] and 130 consecutive orthopedic patients as control [64 girls, 66 boys; mean age 9.2 years (range 2-16 years)] who did not have any skeletal, cranial, thoracic, abdominal or major soft tissue injuries, or any other infectious, metabolic, hematological or malignant tumor disorders. CP and control groups were similar with regard to the above-mentioned hematological parameters. In the CP group, no difference was found between Gross Motor Function Classification System for Cerebral Palsy (GMFCS) level I/II patients and GMFCS level III/IV patients in terms of these hematological parameters. Preoperative blood tests results of pediatric CP patients, walking with or without any supportive devices and undergoing orthopedic interventions, are similar to those of other orthopedic patients. Advanced preoperative hematological tests can only be recommended for CP patients with abnormal blood test results.