Smitirupa Mishra: A Practical Guide to Coagulation Pathway Assessment and Laboratory Interpretation
Smitirupa Mishra, Consultant Pathologist at Sparsh Hospitals and Lab Head at Pathkind Labs, shared a post on LinkedIn:
“Coagulation studies are more than just numbers on a laboratory report. Understanding the coagulation pathway is the key to interpreting them accurately.
For pathology residents and laboratory professionals, a systematic approach to coagulation testing is essential.
A few important points to remember:
- PT and INR – Primarily evaluates the extrinsic and common pathways.
- aPTT – Evaluates the intrinsic and common pathways.
- Thrombin Time (TT) – Assesses the conversion of fibrinogen to fibrin.
- Fibrinogen – Reflects the availability of the essential substrate for clot formation.
- D-dimer – Indicates fibrin breakdown and must always be interpreted in the appropriate clinical context.
When interpreting abnormal results, always consider:
- Isolated prolongation of PT or aPTT.
- Prolongation of both PT and aPTT.
- The role of mixing studies in differentiating factor deficiency from inhibitors.
- Medication history, particularly anticoagulants.
- Clinical conditions such as liver disease and DIC.
One important reminder: A prolonged PT or aPTT is not a diagnosis by itself. It is an indication to investigate further.
The aim of this educational poster is to simplify the coagulation cascade and provide a practical, stepwise approach to interpreting coagulation profiles.
Because accurate laboratory interpretation is the first step towards better clinical decisions.
Sharing this as a quick learning resource for pathology residents, postgraduate students and laboratory professionals.”
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