naa a22 4500 510742661 CHVBK 20180411083033.0 cr unu---uuuuu 180411e20130101xx s 000 0 eng 10.1007/s12630-012-9807-4 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9807-4 Effectiveness of preoperative screening for sickle cell disease in a population with a newborn screening program: a cohort study [Elektronische Daten] [James O'Leary, Isaac Odame, Carolyne Pehora, Pranesh Chakraborty, Mark Crawford] Efficacité du dépistage préopératoire de l'anémie falciforme dans une population à l'aide d'un programme de dépistage néonatal: une étude de cohorte Purpose: Published clinical practice guidelines recommend that all patients from ethnic groups with a high prevalence of sickle cell disease (SCD) undergo preoperative screening for this hemoglobinopathy. Newborn Screening Ontario initiated a universal sickle hemoglobinopathy screening program in 2006 as part of its regional newborn screening program. The primary objective of this study was to determine the effectiveness of selective preoperative screening for SCD based on at-risk ethnicity in Ontario, a region that has a universal newborn sickle hemoglobinopathy screening program. Methods: The hematology laboratory database at our hospital was searched to identify all children who underwent preoperative sickle cell screening in the 42-month period starting in November 2006 (when the newborn sickle hemoglobinopathy screening program was introduced) and ending in April 2010. Medical records of all children testing positive on hemoglobin analysis were reviewed to determine perioperative outcomes. Results: Our search strategy identified 710 children who were born after the introduction of newborn screening and who underwent preoperative screening. Thirty-five of these children had abnormal sickle solubility tests - one (0.14%) was a new diagnosis (not identified by newborn screening), one had been diagnosed previously, and 33 (4.65%) were identified as having sickle cell trait. Sixty children had more than one preoperative screening test performed (range, 2-4). Six of the 35 children with abnormal sickle solubility results underwent repeated testing. Conclusions: Preoperative screening based on at-risk ethnicity alone is an ineffective method of identifying additional children with SCD in Ontario, a population with universal newborn sickle hemoglobinopathy screening. In an effort to avoid unnecessary repeat testing, we propose an algorithm to help physicians decide whether to initiate preoperative sickle cell screening for children. Canadian Anesthesiologists' Society, 2012 O'Leary James Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut Odame Isaac Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada aut Pehora Carolyne Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut Chakraborty Pranesh Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada aut Crawford Mark Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/1(2013-01-01), 54-59 0832-610X 60:1<54 2013 60 12630 https://doi.org/10.1007/s12630-012-9807-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9807-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- O'Leary James Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Odame Isaac Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Pehora Carolyne Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Chakraborty Pranesh Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Crawford Mark Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/1(2013-01-01), 54-59 0832-610X 60:1<54 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer