Related Experiment Video

Updated: Jun 23, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Screening for the risk for bleeding or thrombosis

Mark H Eckman1, John K Erban, Sushil K Singh

  • 1Division of General Internal Medicine, University of Cincinnati Medical Center, PO Box 670535, 231 Albert Sabin Way, Cincinnati, OH 45267-0535, USA.

Annals of Internal Medicine
|February 1, 2003
PubMed

Insights

Routine coagulation testing offers no benefit for assessing bleeding risk in most nonsurgical and surgical patients. It is also not recommended after a first venous thromboembolic event for most individuals.

Area of Science:

  • Clinical Pathology
  • Hematology
  • Diagnostic Testing

Background:

  • Numerous diagnostic tests exist to evaluate patient bleeding or thrombosis risk.
  • Test selection requires careful consideration of clinical context, disease prevalence, test performance, cost, and potential misdiagnosis outcomes.

Purpose of the Study:

  • To review coagulation testing information in three key clinical scenarios.
  • Settings include: nonsurgical hospitalized patients, surgical patients, and individuals experiencing a first venous thromboembolic event.

Main Methods:

  • Systematic literature search of MEDLINE (1966-2002) and reference lists.
  • Included studies on routine coagulation testing, preoperative testing, and factor V Leiden mutation with thromboembolic outcomes.
  • Extracted data from 5 observational studies (nonsurgical) and 12 (preoperative) for sensitivity and specificity analysis.

Main Results:

  • Partial thromboplastin time (PTT) performance for predicting postoperative hemorrhage was analyzed by surgery type.
  • Prolonged PTT did not significantly increase the risk of postoperative complications.
  • Likelihood ratios and confidence intervals were calculated for test results.

Conclusions:

  • Routine coagulation testing is not beneficial for assessing bleeding risk in nonsurgical and surgical patients without liver dysfunction or oral anticoagulant use.
  • Routine testing is generally not recommended following a first venous thromboembolic event.
Abstract

More Related Videos

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

Thrombus Profiling Assay: A Microfluidics-Based Platform for Comprehensively Characterizing Biomechanical Thrombogenesis08:50

Thrombus Profiling Assay: A Microfluidics-Based Platform for Comprehensively Characterizing Biomechanical Thrombogenesis

Published on: January 9, 2026

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...