How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults

Arif H. Kamal, Ayalew Tefferi, Rajiv K. Pruthi

Research output: Contribution to journalReview article

191 Scopus citations

Abstract

The prothrombin time (PT) and activated partial thromboplastin time (APTT) are among the most commonly ordered coagulation tests. In 2005, more than 140,000 PT and more than 95,000 APTT tests were performed at Mayo Clinic. The most common indications for ordering these tests include anticoagulant monitoring, initial evaluation of hemorrhage, and, although not generally indicated, routine preoperative screening. In addition, the bleeding time (BT) test, which is infrequently performed, is still available in certain institutions. Abnormal results from these tests (prolonged PT, APTT, and BT), especially from tests conducted for initial evaluation of hemorrhage or for preoperative screening, may pose a diagnostic dilemma to the non-hematologlst. We review the essential factors affecting test results; provide a practical approach to the evaluation of a prolonged PT, APTT, and BT; and offer suggestions on which reflexive tests are appropriate and when to consider a subspecialty consultation.

Original languageEnglish (US)
Pages (from-to)864-873
Number of pages10
JournalMayo Clinic proceedings
Volume82
Issue number7
DOIs
StatePublished - Jul 2007

ASJC Scopus subject areas

  • Medicine(all)

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