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Mayo Test ID APRI Prolonged Clot Time Profile Interpretation


Specimen Required


 


Useful For

Interpretation of testing performed as part of a profile to determine the cause of prolongation of prothrombin time or activated partial thromboplastin time

 

Interpretation of testing performed as part of a profile for screening for prolonged clotting times and determining the presence of factor deficiencies or inhibitor (eg, factor-specific, lupus-like, or the presence of heparin)

Method Name

Only orderable as part of a profile. For more information see APROL / Prolonged Clot Time Profile, Plasma.

 

Medical Interpretation

Reporting Name

Prolonged Clot Time Prof Interp

Specimen Type

Plasma Na Cit

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen 14 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Clinical Information

When coagulation screening tests are performed to verify normal function of the coagulation system (eg, preoperative, routine examination), they sometimes indicate an abnormality that may be unexplained (ie, prolonged clotting times). This consultation provides validation of the prolongation and as comprehensive a workup as needed to define the abnormality.

 

Possibilities for a cause of prolongation include:

-Artifactual due to high hematocrit (dilution of specimen by anticoagulant if patient hematocrit is 55% or greater)

-Factor deficiencies, congenital or acquired

-Factor inhibitors eg, factor VIII inhibitors (bleeding disorder)

-Lupus anticoagulant (risk for thrombosis or recurrent miscarriage)

-Anticoagulant drug effect eg, (including warfarin [Coumadin or Jantoven], oral anti-Xa inhibitors, oral direct thrombin inhibitors), heparin.

Reference Values

Only orderable as part of a profile. For more information see APROL / Prolonged Clot Time Profile, Plasma.

 

An interpretive report will be provided.

Interpretation

An interpretive report will be provided when testing is completed, noting a presence or absence of a prolonged bleeding disease state.

Cautions

If the patient's hematocrit is 55% or greater, the volume of citrate anticoagulant should be adjusted prior to submitting the specimen for analysis to avoid dilution of plasma by anticoagulant.(1)

 

For optimal results, the patient should not be receiving oral vitamin K inhibitor (eg, warfarin, Coumadin), heparin, low-molecular weight heparin, hirudin (Refludan), argatroban, or fibrinolytic agents (eg, streptokinase, tissue plasminogen activator). If necessary, testing may be performed on patients receiving these treatments. Medications affecting coagulation parameters must be noted on requisition for accurate interpretation of results.

 

If patient has been recently transfused or will be, it is best to perform this study pretransfusion, if possible.

Clinical Reference

1. Clinical and Laboratory Standards Institute. Collection, transport, and processing of blood specimens for testing plasma-based coagulation assays and molecular hemostasis assays; approved guideline-fifth edition. CLSI document H21-A5. CLSI; 2008

2. Kamal AH, Tefferi A, Pruthi RK. How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults. Mayo Clin Proc. 2007;82(7):864-873

3. Favaloro EJ, Lippi G, eds. Hemostasis and Thrombosis: Methods and Protocols. Humana Press; 2017

Method Description

A coagulation expert (clinician or hematopathologist) reviews the laboratory data and an interpretive report is issued.

Day(s) Performed

Monday through Friday

Report Available

3 to 7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

Not Applicable

CPT Code Information

85390-26 Special Coagulation Interpretation

LOINC Code Information

Test ID Test Order Name Order LOINC Value
APRI Prolonged Clot Time Prof Interp 69049-5

 

Result ID Test Result Name Result LOINC Value
603324 Reviewed by 18771-6
603183 Prolonged Clot Time Prof Interp 69049-5