Hematologic evaluation

Several Hematologic disorders may have an impact on the outcomes of surgery. Two of the more common clinical situations faced by the medical consultant are the patient with preexisting anemia and the assessment of bleeding risk. Most data suggest that morbidity and mortality increase as the preoperative hemoglobin level decreases. Hemoglobin levels below 7 or 8 g/dl appear to be associated with significantly more preoperative complications than higher levels. When the directed bleeding history is unreliable or incomplete or when abnormal bleeding is suggested, a formal evluation of hemostasis should be done prior to surgery and should include measurement of prothrombine time, the activated partial thromboplastin time, the platelet count, and the bleeding time.