The preoperative bleeding time test lacks clinical benefit - College of American Pathologists' and American Society of Clinical Pathologists' Position Article

被引:146
作者
Peterson, P
Hayes, TE
Arkin, CF
Bovill, EG
Fairweather, RB
Rock, WA
Triplett, DA
Brandt, JT
机构
[1] Cornell Univ, Coll Med, Dept Pathol, New York, NY USA
[2] Maine Med Ctr, Dept Pathol, Portland, ME 04102 USA
[3] Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA
[4] Dartmouth Hitchcock Med Ctr, Dept Pathol, Lebanon, NH 03766 USA
[5] Univ Mississippi, Med Ctr, Dept Pathol, Jackson, MS 39216 USA
[6] Ball Mem Hosp, Dept Pathol, Muncie, IN 47303 USA
[7] Ohio State Univ, Coll Med, Dept Pathol, Columbus, OH 43210 USA
[8] Boston Univ, Med Ctr, Dept Lab Med, Boston, MA USA
关键词
D O I
10.1001/archsurg.133.2.134
中图分类号
R61 [外科手术学];
学科分类号
摘要
The major conclusions of this position article are as follows: (1) In the absence of a history of a bleeding disorder, the bleeding time is not a useful predictor of the risk of hemorrhage associated with surgical procedures. (2) A normal bleeding time does not exclude the possibility of excessive hemorrhage associated with invasive procedures, (3) The bleeding time cannot be used to reliably identify patients who may have recently ingested aspirin or nonsteroidal anti-inflammatory agents or those who have a platelet defect attributable to these drugs, The best preoperative screen to predict bleeding continues to be a carefully conducted clinical history that includes family and previous dental, obstetric, surgical, traumatic injury, transfusion, and drug histories. A history suggesting a possible bleeding disorder may require further evaluation; such an evaluation may include performance of the bleeding time test, as well as a determination of the platelet count, the prothrombin time, and the activated partial thromboplastin time, In the absence of a history of excessive bleeding, the bleeding time fails as a screening test and is, therefore, not indicated as a routine preoperative test.
引用
收藏
页码:134 / 139
页数:6
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