Bleeding Time(Archived)

Excerpt

The bleeding time is a clinical laboratory test used to evaluate platelet function. It involves creating a standardized incision and timing the cessation of bleeding. The historical indications included the pre-operative assessment of patients taking aspirin or NSAIDs and screening for von Willebrand disease. Unfortunately, it is insensitive and lacks reproducibility. The platelet function assay (ie, PFA-100) has largely replaced bleeding time. Despite standardization of methods, the sensitivity and specificity of the bleeding time for platelet-mediated coagulopathy are low.

Many hospitals and health systems have removed the test without any demonstrated harm. In most cases, a thorough history and physical examination are the only workups needed for the preoperative assessment of bleeding risk. When assessing the clinical effectiveness of platelet aggregation, a modern platelet function assay can provide the necessary information. This is being increasingly utilized in the treatment of intracranial hemorrhage in patients receiving various antiplatelet agents before pooled platelet transfusion.