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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

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1437-4331
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Volume 54, Issue 3

Issues

Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples

Nora Nikolac
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
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/ Ivana Celap
  • Corresponding author
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Email
  • Other articles by this author:
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/ Petra Filipi
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marina Hemar
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marija Kocijancic
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Medical Biochemistry Laboratory of Primorsko-Goranska County Health Care – Rijeka, Rijeka, Croatia
  • Other articles by this author:
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/ Marijana Miler
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ana-Maria Simundic
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Vesna Supak Smolcic
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Clinical Department of Laboratory Diagnostics, Clinical Hospital Center Rijeka, Rijeka, Croatia
  • Department for Medical Informatics, Rijeka University School of Medicine, Rijeka, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alen Vrtaric
  • University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
  • Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-09-30 | DOI: https://doi.org/10.1515/cclm-2015-0650

Abstract

Background: Endogenous interferences are an important source of biased laboratory results. Hemolysis, lipemia and icteria are the main source of endogenous interference in laboratory medicine. Accreditation according to ISO 15189 improves the overall quality of the laboratory procedures. The aim of our study was i) to assess the level of knowledge of Croatian medical biochemists about the proper detection and management of hemolysis, lipemia and icteria; and ii) to identify possible differences in the level of knowledge respective to the laboratory accreditation status.

Methods: An on-line self-report survey was carried out by the Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine during April to May 2015. Survey included 14 statements (Q1–Q14) about procedures for samples with interferences and participants were asked to assess the degree of agreement with the statement using a 4-point Likert scale.

Results: The lowest level of knowledge was observed for statements Q10 (dealing with icteric sample; 40.9% participants agreed with the correct procedure), Q12 (allowable error for interference; 47.2%) and Q11 (dealing with lipemic sample; 60.1%). Almost all participants (97.4%) agreed that laboratories in Croatia should have a harmonized protocol for management of samples with interferences. Participants from accredited laboratories showed higher knowledge of hemolysis detection (p=0.031), rejection of hemolyzed sample (p<0.001), management of icteric samples (p=0.038) and allowable error for interferences (p=0.040).

Conclusions: Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples. Accreditation is associated with higher knowledge about management of samples with interferences.

Keywords: hemolysis; icteria; interferences; laboratory errors; lipemia; preanalytical phase; survey

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About the article

Corresponding author: Ivana Celap, University Department of Chemistry, Sestre Milosrdnice University Hospital, Vinogradska 29, Zagreb, Croatia, Phone/Fax: +385-1-3768-280, E-mail: ; and Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia


Received: 2015-07-09

Accepted: 2015-08-28

Published Online: 2015-09-30

Published in Print: 2016-03-01


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 3, Pages 419–425, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0650.

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