Screening tests for the coagulation cascades (prothrombin time, activated partial thromboplastin test) should be performed prior to surgery if certain risk factors are present.


Patient factors:

(1) family history of a bleeding disorder

(2) patient history of easy bruisability, excessive bleeding, prolonged bleeding after dental extractions, unexplained nosebleeds or other findings suggestive of a bleeding disorder

(3) liver disease

(4) malnutrition

(5) malabsorption

(6) history of or risk factors for lupus anticoagulant

(7) current therapy with coumadin or heparin

(8) major trauma


Surgical factors:

(1) significant bleeding expected during the operative procedure

(2) surgery to the eye, brain or other site where any bleeding may pose a problem


If none of these reasons are present, then preoperative screening with the PT and aPTT is not necessary.


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