{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:07:58Z","timestamp":1774260478994,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T00:00:00Z","timestamp":1444867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,12]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Systematic preoperative coagulation testing is still widely used in children scheduled for surgery, although current guidelines recommend that a bleeding history should be the first choice for hemostatic assessment. We performed a systematic review with meta\u2010analysis to evaluate the pertinence of bleeding questionnaire and screening laboratory testing to detect bleeding disorders (BDs) in children and to predict abnormal surgical blood loss.<\/jats:p><\/jats:sec>Methods<\/jats:title>A search was conducted in PubMed, EMBASE<\/jats:styled-content>, MEDLINE<\/jats:styled-content>(R), Cochrane Central Register of Controlled Trials, Health technology Assessment, and all EBM<\/jats:styled-content> Reviews (Cochrane DSR<\/jats:styled-content>, ACP<\/jats:styled-content> Journal Club, DARE<\/jats:styled-content>, CCTR<\/jats:styled-content>, CMR<\/jats:styled-content>, HTA<\/jats:styled-content>, and NHSEED<\/jats:styled-content> and EBM<\/jats:styled-content> Reviews) up to October 22, 2013. Prospective trials containing 20 children or more and any tests evaluating either the ability of the test to detect a congenital BD or the ability of the test to predict increased surgical blood loss were retained. The quality of the study was judged with the Cochrane Collaboration Tool and two investigators extracted data independently. Data were combined to calculate the pooled diagnostic odds ratio (DOR<\/jats:styled-content>) and their 95% confidence intervals (CI<\/jats:styled-content> 95%). I<\/jats:italic>2<\/jats:sup> statistics were used to assess statistics heterogeneity.<\/jats:p><\/jats:sec>Results<\/jats:title>Data could be extracted from 16 studies. Best results for detecting a congenital abnormality at potential risk for increased surgical blood loss were obtained with the PFA<\/jats:styled-content>\u2010100 (DOR<\/jats:styled-content>\u00a0=\u00a0113.0; 95% CI<\/jats:styled-content>, 22.6\u2013566.2; I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a00%) in two studies, followed by the bleeding time in two other studies (DOR<\/jats:styled-content>\u00a0=\u00a0110.7; 95% CI<\/jats:styled-content>, 24.4\u2013502.3; I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a00%). With a high amount of heterogeneity, questionnaires showed disappointing performances (DOR<\/jats:styled-content>\u00a0=\u00a07.9; 95% CI<\/jats:styled-content>: 3.5\u201317.5; I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a072.6%).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Current evidence does not identify a tool that adequately predicts BDs and\/or abnormal surgical blood loss in children. Questionnaires currently available do not perform well. In the setting of a pediatric coagulation clinic, the PFA<\/jats:styled-content>\u2010100 has the highest chance of detecting a BD. This meta\u2010analysis highlights the weakness of the literature regarding the prediction of perioperative bleeding due to congenital hemostatic disorders in children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12723","type":"journal-article","created":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T11:19:38Z","timestamp":1444907978000},"page":"1216-1226","source":"Crossref","is-referenced-by-count":28,"title":["Ability of hemostatic assessment to detect bleeding disorders and to predict abnormal surgical blood loss in children: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"25","author":[{"given":"Joanne","family":"Guay","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University of Sherbrooke Sherbrooke QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Faraoni","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peri\u2010operative and Pain Medicine Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanny","family":"Bonhomme","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology and Intensive Care Geneva University Hospitals Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annie","family":"Borel Derlon","sequence":"additional","affiliation":[{"name":"Reference Centre for Hemophilia and von Willebrand Disease University Hospital of Caen Caen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Lasne","sequence":"additional","affiliation":[{"name":"Department of Biological Hematology AP\u2010HP H\u00f4pital Necker\u2010Enfants Malades INSERM UMR_S 765 Paris Descartes University Sorbonne Paris Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32835f66cd"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V69.2.454.454"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80384-1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22429"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00177-X"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1055\/s-0037-1619750","article-title":"Repeated coagulation testing in children. 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