Study questions use of two common preop tests

Editor's Note

A significant percentage of two common preoperative tests—prothrombin time (PT) and activated partial thromboplastin time (aPTT)—are unnecessary, this study finds.

PT was ordered unnecessarily in 94.3% of patients and aPPT in 99.9% of patients. PT evaluates the patient’s blood clotting ability, and aPPT determines if heparin therapy is effective.

The study included more than 1 million patients from 19 academic centers and 8 hospital-affiliated surgical centers in 7 states.

Unnecessary tests raise concerns about the costs of such testing and the consequences of false-positive results, the authors say.

Background A substantial fraction of all American healthcare expenditures are potentially wasted, and practices that are not evidence-based could contribute to such waste. We sought to characterize whether Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT) tests of preoperative patients are used in a way unsupported by evidence and potentially wasteful.