Feature Article

Coagulation testing in common clinical scenarios

MICHAEL KRIGSTEIN, JOANNE JOSEPH

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© LZFPICS/istockphoto.com
© LZFPICS/istockphoto.com

Abstract

‘Routine’ coagulation tests may help to confirm and identify the cause of a bleeding disorder, but coagulation results should always be interpreted within the individual patient context and with knowledge of the testing limitations.

Key Points

  • A thorough medical history is the mainstay of assessing patients for underlying bleeding disorders.
  • Standardised bleeding questionnaires are helpful and reduce reliance on patient interpretation.
  • If a bleeding disorder is suspected, initial screening tests include a full blood count, blood film, coagulation profile (activated partial thromboplastin time and prothrombin time) and fibrinogen level.
  • Routine coagulation testing is not required in patients who are taking a nonvitamin K oral anticoagulant; however, it is important to note that if testing is required these medications have an impact on the results.
  • Preoperative coagulation tests are unnecessary unless there is concern about a bleeding disorder.

Figures

© LZFPICS/istockphoto.com
© LZFPICS/istockphoto.com