A single-institution retrospective study of causes of prolonged prothrombin time and activated partial thromboplastin time in the outpatient setting.

Tytuł:: A single-institution retrospective study of causes of prolonged prothrombin time and activated partial thromboplastin time in the outpatient setting.
Autorzy:: Hazim AZ; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Ruan GJ; Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.
Khodadadi RB; Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Slusser JP; Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
Marshall AL; Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Pruthi RK; Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Źródło:: International journal of laboratory hematology [Int J Lab Hematol] 2022 Feb; Vol. 44 (1), pp. 209-215. Date of Electronic Publication: 2021 Oct 05.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Oxford : Blackwell Scientific Publications, c2007-
MeSH Terms:: Ambulatory Care Facilities*
Partial Thromboplastin Time*/methods
Partial Thromboplastin Time*/standards
Prothrombin Time*/methods
Prothrombin Time*/standards
Blood Coagulation Disorders/*blood
Blood Coagulation Disorders/*diagnosis
Adult ; Aged ; Blood Coagulation Disorders/etiology ; Blood Coagulation Tests/methods ; Blood Coagulation Tests/standards ; Clinical Decision-Making ; Disease Management ; Female ; Humans ; Male ; Middle Aged ; Outpatients ; Reference Values ; Retrospective Studies
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Contributed Indexing:: Keywords: Congenital factor deficiency; acquired factor deficiency; anticoagulation; liver disease; vitamin K deficiency
Entry Date(s):: Date Created: 20211006 Date Completed: 20220204 Latest Revision: 20220204
Update Code:: 20240104
DOI:: 10.1111/ijlh.13727
PMID:: 34612006
: Czasopismo naukowe

Pełny tekst

Introduction: An algorithmic approach, termed the prolonged clot time profile (PROCT), consisting of initial screening with prothrombin time (PT) and activated partial thromboplastin time (aPTT), reflexive mixing studies if indicated, and follow-up assays depending on initial testing results, offers an efficient approach to delineate the etiology of a prolonged PT/aPTT. Herein, we present the outcomes of the PROCT in the outpatient setting.
Methods: In this retrospective study, we reviewed medical records of consecutive outpatients who had prolonged PT and/or aPTT noted in the routine coagulation laboratory and who had PROCT ordered in our institutional Special Coagulation Laboratory between 2010 and 2017.
Results: One hundred and six patients, median age 55 years (IQR 30-67), met our study criteria. Twenty-nine patients had normal PT/aPTT, while 77 had persistent abnormalities and underwent reflexive testing. A prolonged PT, aPTT, or PT and aPTT was noted in 27 (35%), 27 (35%), and 23 (30%) respectively. Forty-nine (64%) had an acquired condition, 17 (22%) had a congenital condition, 7 (9%) had unclear etiology, and 4 (5%) were the result of laboratory artifact. The most common known cause of an isolated prolonged PT in our study was vitamin K deficiency in 8 (10%), the most common cause of an isolated prolonged aPTT was lupus anticoagulant in 4 (5%), and the most common cause of prolonged PT and aPTT was liver disease in 11 (14%).
Conclusion: Prolonged PT/aPTT have a wide range of causes, including artifactual prolongation or abnormalities in secondary hemostasis due to both inherited and acquired conditions.
(© 2021 John Wiley & Sons Ltd.)

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