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Laboratory test utilization in the diagnosis of hypercoagulability
S B McKenzie1, C N Clare, L A Smith
1University of Texas Health Science Center at San Antonio, Dept. of Clinical Laboratory Sciences, 7703 Floyd Curl Dr, San Antonio, TX 78284-3900, USA. mckenzie@uthscsa.edu
Summary
Physicians order hypercoagulability tests appropriately, but timing and interpretation are often flawed. Lab results for thrombosis risk are frequently overlooked in patient management.
Area of Science:
- Clinical Pathology
- Hematology
Background:
- Hypercoagulability, an increased tendency to form blood clots, necessitates accurate laboratory evaluation.
- Physician ordering patterns and test utility for hypercoagulability require scrutiny.
Purpose of the Study:
- To assess the appropriateness and clinical utility of laboratory tests for hypercoagulability.
- To identify potential issues in test ordering, timing, and interpretation.
Main Methods:
- Retrospective chart review of 34 patients with thrombosis at an acute care hospital.
- Data collected included patient demographics, clinical history, coagulation testing, result interpretation, and clinical decisions.
Main Results:
- 82% of patients had identifiable thrombosis risk factors.
- Over 40% of coagulation tests yielded abnormal results.
- Up to 33% of tests were performed during anticoagulant therapy; over 50% of abnormal results were unaddressed in physician notes.
Conclusions:
- While patient selection for hypercoagulability testing is appropriate, testing timing and result utilization are suboptimal.
- Inappropriate timing and poor interpretation of coagulation tests hinder effective patient diagnosis and management of thrombosis.