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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