Division of Pulmonary & Critical Care Medicine

In this article and its corresponding editorial, there are 5 questions that can take the place of ordering coagulation studies prior to every bronchoscopy.

These five clinical risk factors are as follows

1. history of anticoagulant therapy
2. history or physical evidence of liver disease, eg, hepatitis, cirrhosis, hepatomegaly, ascites, or jaundice
3. history, family history, or physical evidence of bleeding tendencies, eg, prolonged, delayed, or excessive bleeding, ecchymosis, hematoma, purpura, or petechiae
4. active bleeding and/or preoperative transfusion therapy
5. no reliable history available

If none are present, coagulation studies do not predict clinical bleeding and are not likely to be cost effective.