Bleeding Disorder Referrals to Hematology Clinic: A single institution
experience
Abstract
Introduction The evaluation for an inherited bleeding disorder
can be challenging. Our hematology clinic receives hundreds of referrals
annually for bleeding disorder evaluation due to bleeding symptoms and
secondary to preoperative laboratory testing. Aim To characterize
hematology referrals for bleeding disorder evaluation at our
institution. To describe the diagnostic outcomes, estimate the
proportion diagnosed, and identify referral factors that are associated
with being diagnosed with a bleeding disorder. Methods This is a
single center, retrospective chart review. Patients referred and or seen
for a bleeding disorder evaluation from 07/1/2018 until 06/30/19 were
included. AIC was applied to logistic regression to identify factors
associated with diagnosis of bleeding disorder. Results Of the
373 subjects included, mean (SD) age was 8.3 (5.4) years, 210 (56.3%)
female, 256 (69%) white and 69 (18%) black; 40 (11%) were diagnosed
with a bleeding disorder and 255 ruled out. Of our referred sample, 6%
(21/373) were diagnosed with von Willebrand disease, 4% (14/373) with a
platelet function disorder, and 1% (4/373) with a coagulation factor
deficiency. Forty percent of referrals were for preoperative clearance,
36% for family history, and 57% for symptoms. The odds of a bleeding
disorder diagnosis decreased by 8% for every year increase in age and
were 3 times higher among patients having abnormal coagulation labs at
the time of referral as compared to their counterparts.
Conclusion This study highlights predictive variables for the
presence of an inherited bleeding disorder. These results may contribute
to future large-scale studies.