Overview: Clot Retraction Test
Introduction: The Clot Retraction Test assesses blood clotting ability to diagnose bleeding disorders, causing excessive bruising or bleeding. Following 2023 ASH guidelines, it uses a clotting assay for high accuracy, aiding in coagulation screening. This test is critical for guiding diagnosis, treatment, and improving outcomes in hematology for patients with suspected bleeding disorders.

Other Names: Clot Retraction Assay, Coagulation Test.

FDA Status: Laboratory-developed test (LDT), meeting hematology standards for diagnostic accuracy.

Historical Milestone: Clot retraction testing began in the 1950s with coagulation research. Clotting assays emerged in the 1970s, and by the 2000s, standardized methods improved accuracy.

Purpose: Diagnoses bleeding disorders, guides treatment, and monitors clot retraction in patients with excessive bruising or bleeding.

Test Parameters: 1. Clot Retraction

Pretest Condition: No fasting required. Collect whole blood at any time. Report symptoms like bruising or bleeding, and list medications like anticoagulants.

Specimen: 2-5 mL whole blood (EDTA). Transport in a biohazard bag within 24 hours.

Sample Stability at Room Temperature: 24 hours

Sample Stability at Refrigeration: 48 hours

Sample Stability at Frozen: Not frozen

Medical History: Document bruising, bleeding, or family history of bleeding disorders. Include current medications, especially anticoagulants or antiplatelets.

Consent: Written consent required, detailing the tests purpose, diagnostic implications, and potential need for coagulation therapy.

Procedural Considerations: Uses a clotting assay to assess clot retraction. Results are available in 1-2 days, enabling rapid clinical decisions.

Factors Affecting Result Accuracy: Anticoagulants or improper storage can affect results. Low platelet counts may impair clot retraction.

Clinical Significance: Abnormal clot retraction indicates bleeding disorders like thrombocytopenia, prompting treatment. Normal results suggest alternative diagnoses.

Specialist Consultation: Consult a hematologist for result interpretation. A vascular specialist referral is advised for severe bleeding cases.

Additional Supporting Tests: Platelet count, PT/INR, or bleeding time test to confirm bleeding disorders.

Test Limitations: Results may be affected by medications or platelet function. Clinical correlation is required.

References: ASH Coagulation Guidelines, 2023; Blood, Kottke-Marchant K, 2022.