Routine hemoglobin electrophoresis for pediatric surgery day case in at‑risk populations: Suggested algorithm for screening using clinical risk factors
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Date
2015
Authors
Ademuyiwa, AO
Bode, CO
Adekola, OO
Desalu, I
Elebute, OA
Kushimo, OT
Journal Title
Journal ISSN
Volume Title
Publisher
MedKnow
Abstract
Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of patients for pediatric day care surgery.
Patients and Methods: A prospective study carried out over 12 months. Consecutive patients aged 6 months and older who had day case surgery were recruited to the study. Biodata and relevant clinical data were collated and documented
in a proforma and analyzed using a statistical package for social sciences version 17.
Results: There were 124 patients106 boys and 18 girls. The median age was 3 years. Scrotal lesions were the most
common conditions managed (71.7%). Seventy-eight percent of patients had HbAA, 15.3% had HbAS, and 4.8% had
HbAC while 0.8% each had both HbSC and HbSS. At least one parent of 78.2% knew their Hb phenotype, of which, 79%
were HbAA. Ahistory of jaundice (P = 0.0001), hand and foot syndrome (P = 0.0001), frontal bossing (P = 0.0001), and low
packed cell volume at surgery (P = 0.001) were found significant in predicting hemoglobinopathies. There was no mortality.
Conclusion: Risk factors for hemoglobinopathies from this study included a positive history of jaundice, hand and foot
syndrome, frontal bossing, and anemia. Proposed guidelines for HBE screening include the presence of hemoglobinopathy in
one parent if one parent has sickle cell trait, and the other parent’s genotype is unknown or if any of the risk factors is present.
Description
Scholarly article
Keywords
Algorithm , Day case surgery , hemoglobin electrophoresis screening , Pediatric surgery services , Research Subject Categories::MEDICINE::Surgery
Citation
Ademuyiwa AO, Bode CO, Adekola OO, Desalu I, Elebute OA, Kushimo OT. Routine hemoglobin electrophoresis for pediatric surgery day case in at-risk populations: Suggested algorithm for screening using clinical risk factors. Niger J Clin Pract 2016;19