Prothrombin and Partial Thromboplastin Times as Preoperative Screening Tests

doi:10.1001/archsurg.1982.01380250030007

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Vol. 117 No. 1, January 1982

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Prothrombin and Partial Thromboplastin Times as Preoperative Screening Tests

John M. Eisenberg, MD; John R. Clarke, MD; Steve A. Sussman, MD

Arch Surg. 1982;117(1):48-51.

Abstract

• Preoperative tests of coagulation function have beensuggested to detect patients who are likely to have abnormalbleeding during and after surgery. A study was designed to determinethe yield of prothrombin time (PT) and partial thromboplastintime (PTT), both in discovering patients who are at risk forabnormal bleeding and in inducing changes in patient care oroutcome. Of 750 patients on three surgical services, 611 (81%)patients had no indication of a bleeding disorder on historyor physical examination. Of the 139 patients who had clinicalindications, 25 (18.0%) patients had an abnormal PT or PTT.Of the 611 patients without clinical indications, 480 patientshad the PT or PTT determined, and 13 (2.7%) patients had abnormalresults. One (0.2%) of the 480 patients might have benefitedfrom the test result (this patient required a second operationto control arterial bleeding). The prolonged PT or PTT was ofno apparent clinical importance in the remaining 12 patientswithout indications of bleeding disorders preoperatively. Thelow yield of the PT and PTT in detecting unsuspected bleedingdisorders preoperatively was further obscured by the largernumber of apparently false-positive results (2.3%).

(Arch Surg 1982;117:48-51)

Author Affiliations

From the Section of General Medicine, Department of Medicine, University of Pennsylvania, Philadelphia (Dr Eisenberg) and the Departments of Surgery (Dr Clarke) and Obstetrics and Gynecology (Dr Sussman), Medical College of Pennsylvania, Philadelphia. Dr Eisenberg is the Sol Katz Associate Professor of General Medicine.

Footnotes

Accepted for publication May 20, 1981.

Reprint requests to Section of General Medicine, Third Floor,Silverstein Pavilion, Hospital of the University of Pennsylvania,3400 Spruce St, Philadelphia, PA 19104 (Dr Eisenberg).

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