On behalf of the French Society of Anesthesia and Intensive Care (SFAR), the authors conducted a systematic review of the literature and present their recommendations for the prescription of routine preoperative assessment of hemostasis before a surgical or non-surgical procedure requiring any type of anesthesia.
In essence, it is recommended that bleeding risk should be assessed based on personal and family history and physical examination. Routine tests have a low positive predictive value for bleeding risk and should not be requested in the absence of symptoms. Possible exceptions are children who are not yet walking and non-interviewable adults. In the presence of a history of bleeding, specialist advice should be sought.
Such recommendations are not new but the message has to be repeated on a regular basis….
– Jean-François Hardy