Bleeding versus thrombosis versus both?
| . | Favors thrombotic risk . | Favors hemorrhagic risk . |
|---|---|---|
| DVT indicates deep venous thrombosis; PE, pulmonary embolism; and DIC, disseminated intravascular coagulation. | ||
| History | Prior thromboses Known hypercoagulability Known hemostatic defect | Prior hemostatic failure |
| Bedside Observations | Thrombotic manifestations may include stroke, acute myocardial infarction, acute renal failure, DVT, PE, or purpura fulminans | Epistaxis, bleeding from IV sites or wounds, petechiae and ecchymoses strongly supportive if present, yet strongly negative if all are absent |
| Tempo of DIC | Sub-acute or chronic DIC | Acute fulminant DIC |
| Putative initiator of DIC | Cancer | Sepsis/trauma |
| Acidosis, shock, hypothermia | Neutral | Strongly positive for hemorrhage |
| Labs: Platelets < 50,000/μL | No protective effect | Indicates hemorrhagic risk |
| . | Favors thrombotic risk . | Favors hemorrhagic risk . |
|---|---|---|
| DVT indicates deep venous thrombosis; PE, pulmonary embolism; and DIC, disseminated intravascular coagulation. | ||
| History | Prior thromboses Known hypercoagulability Known hemostatic defect | Prior hemostatic failure |
| Bedside Observations | Thrombotic manifestations may include stroke, acute myocardial infarction, acute renal failure, DVT, PE, or purpura fulminans | Epistaxis, bleeding from IV sites or wounds, petechiae and ecchymoses strongly supportive if present, yet strongly negative if all are absent |
| Tempo of DIC | Sub-acute or chronic DIC | Acute fulminant DIC |
| Putative initiator of DIC | Cancer | Sepsis/trauma |
| Acidosis, shock, hypothermia | Neutral | Strongly positive for hemorrhage |
| Labs: Platelets < 50,000/μL | No protective effect | Indicates hemorrhagic risk |