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Clin Lab Med. 2014 Sep;34(3):453-77. doi: 10.1016/j.cll.2014.06.005. Epub 2014 Jul 28.

Clinical use of the activated partial thromboplastin time and prothrombin time for screening: a review of the literature and current guidelines for testing.

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Duke University School of Medicine, Divisions of Cardiothoracic Anesthesiology and Critical Care, Duke University Hospital, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address:
Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA 30322, USA.
Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, 815 Brinkhous-Bullitt Building, CB# 7525, Chapel Hill, NC 27599-7525, USA.
Department of Pathology & Laboratory Medicine, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, USA.


Although the activated partial thromboplastin time, prothrombin time, and international normalized ratio are widely used in routine preoperative testing, these hemostatic tests are not reliable predictors of perioperative bleeding in patients without known bleeding risk factors. In contrast, a preoperative bleeding history and physical examination are usually obtained in an attempt to identify important bleeding risk factors. However, these coagulation tests are used extensively for monitoring anticoagulation with different pharmacologic agents.


Activated clotting time; Activated partial thromboplastin time; Anticoagulation; Monitoring; Prothrombin time; Surgery

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