‘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.
- 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.