Prothrombin Time (PT):

Prothrombin time is a laboratory test that measures the time it takes for blood plasma to clot. More
specifically, PT assesses the activity of the extrinsic pathway of the coagulation cascade, a series of
events that lead to the formation of a blood clot. The extrinsic pathway is primarily triggered by external
trauma that causes bleeding.

During the PT test, a blood sample is mixed with a substance called thromboplastin, which initiates the
clotting process. The time it takes for fibrin strands to form in the blood sample is then measured. Fibrin
strands are essential for clot formation and play a crucial role in stopping bleeding.

INR (International Normalized Ratio):

INR is a standardized unit of measurement for PT results. The need for standardization arises from the
fact that PT values can vary among different laboratories due to differences in reagents, equipment, and
testing methodologies. INR was introduced to provide a uniform system for reporting PT results,
ensuring consistency and comparability across various labs.

Formula for INR Calculation:

INR = (Patient's PT / Mean Normal PT) ISI

The INR formula includes three main components:

1. Patient's PT: This is the prothrombin time of the individual being tested, representing their
blood clotting time.

2. Mean Normal PT: This is the average prothrombin time of a group of healthy individuals. It
serves as a reference point to which the patient's PT is compared.

3. ISI (International Sensitivity Index): This is a correction factor specific to the thromboplastin
reagent used in the PT test. Different thromboplastin reagents have varying sensitivities to
clotting factors, and the ISI adjusts for these differences.

The formula allows for the normalization of PT results, making them comparable across different
laboratories and testing conditions. The resulting INR value provides a standardized way to interpret and
manage anticoagulation therapy.

Significance of Using INR:

1. Standardization: INR enables standardization of PT results, ensuring consistency and reliability in

interpreting coagulation status.

2. Inter-laboratory Comparisons: Health professionals can compare INR results from different
laboratories more confidently, facilitating consistent patient care.

3. Anticoagulation Therapy Management: INR is crucial for monitoring patients on anticoagulant

therapy (e.g., warfarin). Maintaining INR within a target therapeutic range helps balance the risk
of bleeding and clotting.