Biphasic Activated Partial Thromboplastin Time Waveform and Adverse Events in Non–Intensive Care Unit Patients

• Published in: American journal of clinical pathology Vol. 121; no. 1; pp. 138 - 141
• Main Authors: Smith, Eve Y., Charles, Linda A., Van Cott, Elizabeth M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.01.2004
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Coagulation - physiology; Blood Transfusion; Disseminated Intravascular Coagulation - blood; Emergency Service, Hospital; Humans; Image Processing, Computer-Assisted; Intensive Care Units; Investigative techniques, diagnostic techniques (general aspects); Length of Stay; Medical sciences; Middle Aged; Online Systems; Optics and Photonics; Outcome and Process Assessment (Health Care); Partial Thromboplastin Time; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Photometry - instrumentation; Human; Partial thromboplastin time; Anatomic pathology; Toxicity; Intensive care unit
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/W4F7892WJE6Y1W7Y

The purpose of the present study was to determine whether the presence of a biphasic activated partial thromboplastin time (aPTT) waveform (BPW) is associated with adverse clinical outcomes among patients not in an intensive care unit (ICU). Consecutive patients from the emergency department or non-ICU inpatient floors with a BPW (n = 24) were enrolled prospectively, along with 24 matched control subjects with a normal aPTT waveform. Patients with a BPW had a significantly longer hospital stay (mean [median], 16.9 [11] vs 4.9 [2.5] days; P = .011), were more likely to have a positive microbial culture (16/24 [67%] vs 3/24 [13%]; P < .001), were transferred more often to an ICU (6/24 [25%] vs 0/24 [0%]; P = .010), and were more likely to receive an RBC transfusion (11/24 [46%] vs 5/24 [21%]; P = .047) or a fresh frozen plasma transfusion (5/24 [21%] vs 0/24 [0%]; P = .025). Emergency department patients with a BPW were more likely to be admitted (11/11 vs 5/11; P = .018). These results suggest that the BPW is associated with an increased rate of adverse events among non-ICU patients. Further study in this population is warranted.