Do your physicians routinely order Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT) screenings for surgical patients? A new study suggests the common pre-op tests are often unnecessary.

Researchers examined the records of more than 1 million patients who underwent elective surgery at 27 medical facilities between 2009 and 2012. They found that approximately 680,000 of those patients had been given one or both of the PT and aPTT tests, which analyze a patient's ability to clot and check if heparin therapy is effective in the patient, respectively.

The researchers then looked at whether the tests were administered unnecessarily, which they defined as PT tests performed on patients with no history of abnormal bleeding, warfarin therapy, vitamin K-dependent clotting factor deficiency or liver disease and aPTT tests given to patients with no history of heparin treatment, hemophilia, lupus anticoagulant antibodies or von Willebrand disease. According to the findings, 94% of the patients needlessly underwent PT tests and a whopping 99% received unnecessary aPTT tests.

Physicians are incorrectly ordering the diagnostic tests for all patients before surgery, instead of requiring the screenings only for those at risk for blood disorders, say the study's authors, who note the routine use of the tests contributes to rising costs in health care and can result in false positives. They warn doctors to rethink their use of the pre-op screenings, writing that "useless tests are clinically inappropriate because they consume resources, yet bring no benefit to patients or clinicians."

"There are still some doctors that order tests not needed in an ASC," says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer of Source Medical in Mt. Pleasant, S.C. "They should ask themselves, 'Would I cancel the surgery based on the results?'"

Kendal Gapinski