A Practical Approach to Pediatric Patients Referred With an Abnormal Coagulation Profile
| Autor: | Monica, Acosta, Rachel, Edwards, Ian M, Jaffee, E Ian, Jaffe, Donald L, Yee, Donald H, Mahoney, Jun, Teruya |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Pathology and Forensic Medicine Predictive Value of Tests Risk Factors Internal medicine medicine Coagulopathy Humans Family history Child Blood Coagulation Referral and Consultation Retrospective Studies Prothrombin time Hematology medicine.diagnostic_test business.industry Medical record Retrospective cohort study General Medicine Blood Coagulation Disorders medicine.disease Surgery Medical Laboratory Technology Predictive value of tests Prothrombin Time Female Partial Thromboplastin Time business Partial thromboplastin time |
| Zdroj: | Archives of Pathology & Laboratory Medicine. 129:1011-1016 |
| ISSN: | 1543-2165 0003-9985 |
| DOI: | 10.5858/2005-129-1011-apatpp |
| Popis: | Context.—Workup for prolonged prothrombin time (PT) and activated partial thromboplastin time (PTT) is a frequent referral to a Hematology and Coagulation Laboratory. Although the workup should be performed in a timely and cost-effective manner, the complete laboratory assessment of the coagulation state has not been standardized. Objective.—To determine which clinical and laboratory data are most predictive of a coagulopathy and to formulate the most efficient strategy to reach a diagnosis in patients referred for abnormal coagulation profiles. Design.—Retrospective case review. Medical records of 251 patients referred for prolonged PT and/or PTT to our Hematology Service between June 1995 and December 2002 were reviewed. Results.—The study included 135 males and 116 females with a mean age of 7.0 years. A personal history of bleeding was reported in 137 patients, and a family history of bleeding was reported in 116 patients. Fifty-one patients (20%) had a coagulopathy (ie, a bleeding risk). Factors predictive of a bleeding risk were a positive family history of bleeding (P < .001) and a positive personal history of bleeding (P = .001). Of 170 patients with findings of normal PT and PTT values on repeat testing, 14 were subsequently diagnosed with a coagulopathy. Two of these patients reported no positive personal or family history of bleeding. Conclusions.—Coagulopathy was identified in 20% of the children referred for abnormal PT and/or PTT. In the absence of a personal or family history of bleeding, a normal PT and/or PTT on repeat testing has a negative predictive value of more than 95%. |
| Databáze: | OpenAIRE |
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