Utilization Of Coagulation Studies in Emergency Department, A chart review.

Aim: To determine the prevalence of abnormal coagulation studies in emergency department (ED) patients, and to investigate if a relationship exists between patients’ chief complaints, past medical history or drug history; and abnormal coagulation studies results.

Materials and Methods: In this retrospective chart review study, ED records were obtained for patients who had undergone coagulation studies. ED records were reviewed for certain data including demographics, chief complaint, past medical history, drug history, and clinical impression. Descriptive and statistical analyses were performed.

Results: A total of 322 charts were reviewed. 13 patients (4.04%) had an abnormal International normalized ratio (INR); of which 6 patients (46.2%) were on Warfarin therapy. Although chest pain was the most prevalent chief complaint (10.4%), no statistically significant relationship was found between chief complaints and INR level. Patients with past medical history indicative of thromboembolic risk had an 8.8 likelihood ratio to have an abnormal INR. Warfarin intake has a statistically significant likelihood of abnormal INR (32.8 LR). Coagulation profile was repeated in 4.35% of patients with a request gap mean of 6 days.

Conclusions: Chief complaints presenting to ED are not good predictors for INR abnormalities. However, warfarin therapy and past medical history of thromboembolic events have a strong association with abnormal INR levels. Routine coagulation studies are not indicated in all patients presenting to ED.

Keyword: Coagulation, emergency department, utilization