Related Experiment Videos
Prothrombin and partial thromboplastin times as preoperative screening tests
Archives of Surgery (Chicago, Ill. : 1960)
|January 1, 1982
Summary
Preoperative prothrombin time (PT) and partial thromboplastin time (PTT) tests have low yield in detecting bleeding risks. Routine screening may not significantly alter patient care or outcomes, with many false positives.
Area of Science:
- Medical Diagnostics
- Surgical Patient Management
- Hematology
Background:
- Preoperative coagulation tests, including prothrombin time (PT) and partial thromboplastin time (PTT), are used to identify patients at risk of bleeding.
- The clinical utility and yield of these tests in routine preoperative screening remain subjects of investigation.
Purpose of the Study:
- To evaluate the diagnostic yield of PT and PTT in identifying patients with bleeding risks.
- To determine if these tests lead to changes in patient care or improve surgical outcomes.
Main Methods:
- A prospective study involving 750 patients across three surgical services.
- Analysis of coagulation test results (PT and PTT) in relation to clinical indications of bleeding disorders.
- Assessment of the impact of test results on patient management and outcomes.
Main Results:
- Of 750 patients, 611 (81%) had no preoperative indication of a bleeding disorder.
- Among 139 patients with clinical indications, 25 (18.0%) had abnormal PT or PTT results.
- In patients without clinical indications, 13 (2.7%) of 480 tested had abnormal results, with only one potentially benefiting from the test (requiring surgery for arterial bleeding).
Conclusions:
- Routine preoperative PT and PTT testing show a low yield in detecting unsuspected bleeding disorders.
- The high rate of abnormal results in patients without clinical indications suggests a significant number of false positives.
- The clinical significance and impact on patient care from these routine tests appear limited.