{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T22:58:26Z","timestamp":1778021906928,"version":"3.51.4"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Published guidelines are available to assist in the management of patients with inherited bleeding disorders in the elective surgical setting however good quality outcome data is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>\u2010 Evaluate the outcomes of adult patients with inherited bleeding disorders, who received factor replacement for elective surgery in NSW\/ACT, Australia.<\/jats:p><jats:p>\u2010 Assess adherence to relevant guidelines including Haemophilia Treatment Centre (HTC) utilisation and appropriate factor replacement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective analysis was performed between 2000 and 2018 to describe patient characteristics, surgical details, factor provision and outcomes. Univariate analysis was used to determine variables associated with guideline adherence. Covariates with <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.1 were included in the multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1065 surgeries were performed on 571 patients. Diagnoses included Haemophilia A (43.5%), Haemophilia B (9.7%), von Willebrand disease (VWD) (45.3%) and rare bleeding disorders (RBDs) (1.6%). Bleeding complications were reported in 14 surgeries and 19 patients received factor replacement beyond standard duration of prophylaxis. Approximately 50% of all surgeries were performed in a HTC. Multivariate analysis demonstrated that diagnosis, surgical specialty, sex and year (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) were associated with non\u2010compliance with variable pattern within each category. Factor replacement was as expected except for plasma\u2010derived Factor VIII\/VWF usage in patients with VWD undergoing major bleeding risk surgery. VWD classification (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) was associated with this deviation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low complication rates demonstrate that elective surgery in Australia is being safely performed in patients with inherited bleeding disorders however non\u2010compliance with published guidelines exists highlighting areas of practice and policy discrepancies that warrant further exploration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14365","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T04:54:17Z","timestamp":1623992057000},"page":"744-750","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Elective surgery in patients with inherited bleeding disorders: A retrospective analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2198-2675","authenticated-orcid":false,"given":"Lisa","family":"Clarke","sequence":"first","affiliation":[{"name":"Pathology Services Australian Red Cross Lifeblood  Sydney Alexandria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peta M","family":"Dennington","sequence":"additional","affiliation":[{"name":"Pathology Services Australian Red Cross Lifeblood  Sydney Alexandria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Curnow","sequence":"additional","affiliation":[{"name":"Department of Haematology Westmead Hospital  Westmead Sydney"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12899"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02909.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1605568"},{"key":"e_1_2_9_5_1","volume-title":"Treatment and Supply of Factor VIII to Patients With Haemophilia and Von Willebrands Disorder","author":"NSW Department of Health","year":"2020"},{"key":"e_1_2_9_6_1","volume-title":"Guidelines for the Management of Haemophilia in Australia","author":"Australian Haemophilia Centre Directors' Organisation AHCDO","year":"2016"},{"key":"e_1_2_9_7_1","volume-title":"Common Procedures and Associated Bleeding Risks","author":"Epocrates","year":"2018"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50123"},{"issue":"4","key":"e_1_2_9_9_1","article-title":"Diagnosis and management of von Willebrand disease in Australia","volume":"3","author":"Favaloro EJ","year":"2018","journal-title":"Ann Blood"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02206.x"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.14365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hae.14365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.14365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:16:41Z","timestamp":1693307801000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.14365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/hae.14365"],"URL":"https:\/\/doi.org\/10.1111\/hae.14365","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,17]]},"assertion":[{"value":"2021-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}