PB0230 - First insight into the presurgical APTT determination practice in Nigeria through a nationwide explorative survey

Sunday, June 25, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

Eyiuche D. Ezigbo, PhD (she/her/hers)

Senior Lecturer
eyiuche.ezigbo@unn.edu.ng
Enugu, Enugu, Nigeria

Co-Author(s)

Ue

Uchechukwu ezomike

Consultant
University of Nigeria Teaching Hospital
Enugu, Enugu, Nigeria
PY

Polit Yelpoji

Lecturer 1
3Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, College of Health Sciences University of Jos
Jos, Plateau, Nigeria

Presenting Author(s)

Helen C. Okoye, MD (she/her/hers)

Consultant Haematologist
College of Medicine, University of Nigeria
Enugu, Nigeria

Co-Author(s)

Theresa U. Nwagha, MD, MPH, FMCPath, MSc (she/her/hers)

Consultant Haematologist
University of Nigeria , College of Medicine Ituku Ozalla Campus
Enugu, Enugu, Nigeria
CO

Chidinma Onwuka

Consultant
Faculty of Medical Science, College of Medicine. University of Nigeria Nsukka/ University of Nigeria Teaching Hospital, Ituku/Ozalla
Enugu, Enugu, Nigeria
OO

Olayanju Olusola

Professor
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti
Ekiti, Ekiti, Nigeria

Background: It has recently been discovered that some contact phase deficiencies (factor XII, prekallikrein, or high molecular weight kininogen) are not rare but actually common in the African population. They are usually detected in a preoperative screening by an isolated prolonged activated partial thromboplastin time (APTT).

Aims: : Our aim was to gain insight into the awareness of Nigeria physicians for the evaluation protocol for an isolated prolonged APTT

Methods: This study used a self-administered online survey that was distributed from August –September 2022 among practitioners who perform surgeries

Results: 94 practitioners from 20 hospitals participated in the survey. Most of them worked in general surgery 28% or paediatrics 21%. A history of bleeding symptoms was the main reason for an APTT (60%) and only a few practitioners never (16%) or always (5%) determine an APTT prior to surgery independent of the field of speciality or hospital. If a case of isolated prolonged APTT occurs, the surgery is usually postponed or not, no further tests are raised, and the surgery is performed with preventive therapy (37%). This drops to 19% when taking into account that an APTT is primarily raised in cases of suspected bleeding. 30% raise additional tests, postpone the surgery, and issue a preventive therapy (17/57). 96% of physicians who collect an APTT indicated that a pathologic finding raises the surgery costs for the patient.

Conclusion(s): Only a small proportion of patients who undergo surgery seem to have an APTT recorded in Nigerian healthcare. Even if a pathological APTT is obtained, usually no additional tests but a preventive treatment is issued. No detailed explanation about the diagnostic procedure of an isolated prolonged APTT could be obtained.