Assessing preoperative bleeding risk using international normalized ratio and activated partial thromboplastin time:...

Area of Science:

• Clinical Pathology
• Surgical Risk Assessment
• Evidence-Based Medicine

Background:

• Prothrombin time (PT) and activated partial thromboplastin time (APTT) are standard preoperative tests for bleeding risk.
• Guidelines on routine coagulation testing show variability, with a trend toward risk-stratified approaches.
• The general utility of these tests as a screening tool is debated.

Conclusions:

• Coagulation test results (PT, APTT) are not consistently linked to bleeding risk in minor and most major elective surgeries.
• Preoperative PT may be associated with bleeding outcomes in patients with advanced liver disease undergoing major abdominal surgery.
• Routine coagulation screening may not be beneficial for most surgical patients.