The preoperative bleeding time test: assessing its clinical usefulness

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The bleeding time test can aid in the diagnostic evaluation of patients with clinical hemorrhagic disorders or a history of bleeding. However, its low positive predictive value in predicting perioperative bleeding should force one to abandon it as a routine preoperative screening test.


Many methodologic factors affect the bleeding time, including the length, depth, orientation, and location of the incision and whether a blood pressure cuff is used. The bleeding time also varies with age, sex, blood group, medication use, skin characteristics, and diet.

A prolonged bleeding time itself is nonspecific and is not pathognomonic of a single disease entity.

Many studies have shown no association between a prolonged preoperative bleeding time and increased perioperative blood loss.

Even though a prolonged preoperative bleeding time usually lacks clinical significance, it often leads to additional laboratory tests, postponement of surgery, increased length of stay, and possibly inappropriate treatment.



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