Critical Values in the Coagulation Laboratory
Open Access
- 1 December 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Clinical Pathology
- Vol. 136 (6), 836-841
- https://doi.org/10.1309/ajcp8o8gipppnush
Abstract
Critical values are vital to safe clinical and laboratory practice. To address the lack of information on critical values in coagulation, pattern-of-practice surveys were distributed to members of the North American Specialized Coagulation Laboratory Association. More than 70% of respondents had critical values for commonly performed tests. Median values were as follows: prothrombin time, more than 37 seconds; international normalized ratio, more than 5; activated partial thromboplastin time, more than 100 seconds; and fibrinogen level, less than 100 mg/dL. Critical value reporting generated a significant workload, with up to 15% of these tests yielding critical results. The median time to report critical values was 7 minutes for inpatients. Despite the lack of guidelines surrounding critical values in coagulation, this survey confirms that laboratories have reasonable and uniform practices. It also provides critical value medians and ranges for a wide range of tests. Laboratories without critical values or in the process of reviewing their values may find this survey of their peers useful.Keywords
This publication has 27 references indexed in Scilit:
- Development of North American Consensus Guidelines for Medical Laboratories That Perform and Interpret Platelet Function Testing Using Light Transmission AggregometryAmerican Journal of Clinical Pathology, 2010
- Laboratory defined critical value limits: How do hospital physicians perceive laboratory based critical values?Clinical Biochemistry, 2009
- Results of an External Proficiency Testing Exercise on Platelet Dense-Granule Deficiency Testing by Whole Mount Electron MicroscopyAmerican Journal of Clinical Pathology, 2009
- Guidelines for the diagnosis and management of disseminated intravascular coagulationBritish Journal of Haematology, 2009
- Pharmacology and Management of the Vitamin K Antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2008
- Variability in clinical laboratory practice in testing for disorders of platelet functionThrombosis and Haemostasis, 2005
- Activated Partial Thromboplastin Time and Outcome After Thrombolytic Therapy for Acute Myocardial InfarctionCirculation, 1996
- Bleeding During Antithrombotic Therapy in Patients With Atrial FibrillationArchives of Internal Medicine, 1996
- Haemorrhagic and Thromboembolic Complications versus Intensity of Treatment of Venous Thromboembolism with Oral AnticoagulantsActa Medica Scandinavica, 1988
- Clotting factor levels and the risk of diffuse microvascular bleeding in the massively transfused patientBritish Journal of Haematology, 1987