Coagulation panel

Preparing for surgery or a procedure, bruising easily or bleeding slowly stopping? The coagulation panel checks three basic clotting indicators in one collection: prothrombin time (PT), APTT and fibrinogen. It shows whether blood clots normally, important before procedures and with bleeding tendency.

Who the panel is for

• people before surgery or another procedure when a surgeon or anaesthetist requests clotting checks;
• people who bruise easily or frequently bleed from the nose and gums;
• women with heavy prolonged periods;
• people whose bleeding after a cut, tooth extraction or delivery lasted longer than usual;
• people with liver disease because the liver produces most clotting proteins;
• people taking warfarin or other anticoagulants when a doctor requests monitoring.

What the panel detects

When a vessel is damaged, blood proteins (clotting factors) and platelets form a clot together. The panel checks different parts of this process:

• Prothrombin time (PT), also expressed as INR: how quickly blood clots through one part of the system. It also monitors warfarin treatment.
• APTT: checks another part of the clotting system. It is prolonged, for example, in haemophilia and heparin treatment.
• Fibrinogen: the protein forming a clot. Low levels may contribute to bleeding, while raised levels most often accompany inflammation.

The panel does not measure platelets or assess thrombosis tendency. If a doctor wants a blood count and D-dimer alongside clotting, there is an extended coagulation panel.

The procedure and preparation

Blood is taken from a vein, taking a few minutes. Morning fasting is recommended because a fatty meal can cloud the sample and interfere with measurement.

Do not stop anticoagulants such as warfarin, heparin, rivaroxaban, apixaban or dabigatran yourself for collection. State the medicine and last dose timing because many affect results.

What your result means

• Normal result: basic clotting-system components work normally. Nevertheless, the panel does not detect every bleeding tendency, such as mild von Willebrand disease or platelet-function disorders, so pronounced bleeding may require further tests.
• Prolonged PT or APTT: may result from medicines, vitamin K deficiency, liver disease or clotting-factor deficiency. Sometimes the sample itself causes it, so a doctor usually first repeats an asymptomatic abnormality.
• Raised fibrinogen: most often accompanies infection or inflammation, pregnancy, smoking or oestrogen medicines and does not mean a clotting disorder.
• Low fibrinogen: is less common and may occur with severe liver disease, congenital deficiency or substantial consumption in severe illness.

A doctor interprets results alongside medicines, bleeding history and other findings. If taking anticoagulants and noticing blood in urine or stool, black stools, vomiting blood or bleeding that will not stop, seek medical attention or call 194 or 112 immediately.

How to arrange testing

You can have blood taken without an appointment or referral at one of our branches across Croatia (listed under Contact). Prices for all tests and panels are available in the price list. If a surgeon requests broader investigation, there is a Preoperative panel, containing blood count, liver and kidney tests, electrolytes, glucose and urinalysis alongside PT, APTT and fibrinogen.

Frequently asked questions

Do I need to fast?

It is recommended. Come in the morning after overnight fasting; water is permitted. A fatty meal can cloud the sample and interfere with measurement.

Must I stop anticoagulant medicines?

Not on your own. The prescribing doctor and surgeon decide whether and when to stop a medicine before a procedure.

How long are preoperative tests valid?

This depends on the institution performing the procedure. Check requested tests and maximum result age before collection.

Does the panel detect thrombosis tendency?

No. Normal PT and APTT do not exclude clot predisposition; specific tests identify inherited predisposition. For suspected thrombosis a doctor requests D-dimer and urgent investigation.