Meta-analytic analysis of the role of hemostatic evaluation in optimizing surgical results

Introduction: pre-surgical clinical assessment constitutes an essential practice in internal medicine, focused on the identification of risk factors to reduce perioperative morbidity and mortality. Objective: this study seeks to critically evaluate the effectiveness of preoperative coagulation tests to predict bleeding complications in elective non-cardiac surgeries, in order to validate their clinical relevance and adjust practices to real needs based on solid evidence. Method: a meta-analysis approach was employed to synthesize data from multiple studies examining the correlation between preoperative coagulation testing and intra- and postoperative bleeding complications. Study selection was based on rigorous criteria to include only those with patients without a history of hematological diseases who underwent elective non-cardiac surgeries. Results: the results indicate that alterations in coagulation tests are not significantly associated with an increased risk of hemorrhagic complications, as evidenced by a relative risk (RR) of less than one. This suggests that routine performance of these tests in the study population may not be necessary and does not contribute significantly to the safety of the surgical patient. Conclusions: the study supports a review of clinical guidelines to reduce unnecessary defensive medical practices and encourage evidence-based decisions. It is recommended to limit preoperative coagulation testing to patients with identifiable risk factors or clinical manifestations of hemostatic disorders, avoiding widespread and unsubstantiated procedures that overload health systems without improving clinical outcomes