Burkhardt et al: Evaluating preoperative coagulation panels in dogs undergoing liver lobectomy for primary liver tumors: A multi-institutional retrospective study
Veterinary Surgery 7, 2024

🔍 Key Findings

20.6% of dogs had a preoperative prolongation in PT or aPTT, but only 5.6% had both prolonged.
Hemangiosarcoma was the only tumor type significantly associated with both PT and aPTT prolongation (37.5% of hemangiosarcoma cases, p < .001).
Dogs with both PT and aPTT prolongations were 6.5× more likely to have emergency surgery (p < .001) and 2.5× more likely to have hemoabdomen (p = .0022).
60% of dogs with both PT and aPTT prolongation required blood transfusion (p < .001).
Only 1.9% of all dogs had both PT and aPTT prolonged by >25%, suggesting limited clinical utility of routine PT/aPTT testing.
Platelet count <50,000/μL was rare (1.5%) and not associated with PT/aPTT changes or transfusions.
Routine PT/aPTT testing offers low diagnostic yield in elective liver lobectomy cases.
Authors recommend case-by-case PT/aPTT screening, especially when hemangiosarcoma or bleeding tendencies are suspected.

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Burkhardt et al: Evaluating preoperative coagulation panels in dogs undergoing liver lobectomy for primary liver tumors: A multi-institutional retrospective study
Veterinary Surgery 7, 2024

🔍 Key Findings

20.6% of dogs had a preoperative prolongation in PT or aPTT, but only 5.6% had both prolonged.
Hemangiosarcoma was the only tumor type significantly associated with both PT and aPTT prolongation (37.5% of hemangiosarcoma cases, p < .001).
Dogs with both PT and aPTT prolongations were 6.5× more likely to have emergency surgery (p < .001) and 2.5× more likely to have hemoabdomen (p = .0022).
60% of dogs with both PT and aPTT prolongation required blood transfusion (p < .001).
Only 1.9% of all dogs had both PT and aPTT prolonged by >25%, suggesting limited clinical utility of routine PT/aPTT testing.
Platelet count <50,000/μL was rare (1.5%) and not associated with PT/aPTT changes or transfusions.
Routine PT/aPTT testing offers low diagnostic yield in elective liver lobectomy cases.
Authors recommend case-by-case PT/aPTT screening, especially when hemangiosarcoma or bleeding tendencies are suspected.

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Multiple Choice Questions on this study

In Burkhardt 2024 et al., on coagulation testing in liver lobectomy, which statement best reflects the relationship between platelet count <50,000/μL and surgical outcomes?

A. Strongly predicted transfusion need

B. Associated with higher bleeding risk

C. Linked to PT prolongation

D. No correlation with outcomes

E. Required routine plasma transfusion

Answer: No correlation with outcomes

Explanation: Low platelet counts were rare and not associated with PT/aPTT prolongation or transfusions.

In Burkhardt 2024 et al., on coagulation testing in liver lobectomy, which liver tumor type was significantly associated with both PT and aPTT prolongation?

A. Hepatocellular adenoma

B. Hepatocellular carcinoma

C. Cholangiocellular carcinoma

D. Hepatic hemangiosarcoma

E. Neuroendocrine carcinoma

Answer: Hepatic hemangiosarcoma

Explanation: Only hemangiosarcoma showed a significant association with both PT and aPTT prolongation (p < .001).

In Burkhardt 2024 et al., on coagulation testing in liver lobectomy, what percentage of dogs had both PT and aPTT prolonged preoperatively?

A. 1.9%

B. 5.6%

C. 12.3%

D. 20.6%

E. 37.5%

Answer: 5.6%

Explanation: Only 5.6% of dogs had both PT and aPTT prolonged before surgery, indicating limited diagnostic yield of routine panels.

In Burkhardt 2024 et al., on coagulation testing in liver lobectomy, what did the authors recommend regarding preoperative PT and aPTT testing?

A. Should always be performed in all liver lobectomies

B. Should only be used in cats with liver disease

C. Should be performed only when thrombocytopenia is confirmed

D. Should be reserved for cases with bleeding tendencies or hemangiosarcoma suspicion

E. Should be replaced with thromboelastography

Answer: Should be reserved for cases with bleeding tendencies or hemangiosarcoma suspicion

Explanation: Authors concluded that routine testing is low-yield and should be considered on a case-by-case basis.

In Burkhardt 2024 et al., on coagulation testing in liver lobectomy, dogs with both PT and aPTT prolongation were how much more likely to undergo emergency surgery?

A. 1.5 times

B. 2 times

C. 4 times

D. 6.5 times

E. 10 times

Answer: 6.5 times

Explanation: Dogs with both PT and aPTT prolonged were 6.5 times more likely to require emergency surgery.

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