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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

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1437-4331
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Volume 57, Issue 10

Issues

Pre-analytical practices for routine coagulation tests in European laboratories. A collaborative study from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM)

Ann Helen Kristoffersen
  • Corresponding author
  • Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
  • Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Anne V. Stavelin
  • Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Eva Ajzner / Gunn B.B. Kristensen
  • Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sverre Sandberg
  • Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
  • Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
  • Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marjan Van Blerk / Steve Kitchen
  • UK NEQAS for Blood Coagulation, Sheffield, UK
  • Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Dagmar Kesseler / Timothy A.L. Woods / Piet Meijer
Published Online: 2019-05-14 | DOI: https://doi.org/10.1515/cclm-2019-0214

Abstract

Background

Correct handling and storage of blood samples for coagulation tests are important to assure correct diagnosis and monitoring. The aim of this study was to assess the pre-analytical practices for routine coagulation testing in European laboratories.

Methods

In 2013–2014, European laboratories were invited to fill in a questionnaire addressing pre-analytical requirements regarding tube fill volume, citrate concentration, sample stability, centrifugation and storage conditions for routine coagulation testing (activated partial thromboplastin time [APTT], prothrombin time in seconds [PT-sec] and as international normalised ratio [PT-INR] and fibrinogen).

Results

A total of 662 laboratories from 28 different countries responded. The recommended 3.2% (105–109 mmol/L) citrate tubes are used by 74% of the laboratories. Tube fill volumes ≥90% were required by 73%–76% of the laboratories, depending upon the coagulation test and tube size. The variation in centrifugation force and duration was large (median 2500 g [10- and 90-percentiles 1500 and 4000] and 10 min [5 and 15], respectively). Large variations were also seen in the accepted storage time for different tests and sample materials, for example, for citrated blood at room temperature the accepted storage time ranged from 0.5–72 h and 0.5–189 h for PT-INR and fibrinogen, respectively. If the storage time or the tube fill requirements are not fulfilled, 72% and 84% of the respondents, respectively, would reject the samples.

Conclusions

There was a large variation in pre-analytical practices for routine coagulation testing in European laboratories, especially for centrifugation conditions and storage time requirements.

This article offers supplementary material which is provided at the end of the article.

Keywords: activated partial thromboplastin time; coagulation tests; fibrinogen; haemostasis; pre-analytical phase; prothrombin time

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About the article

Corresponding author: Ann Helen Kristoffersen, MD, PhD, Department of Medical Biochemistry and Pharmacology, Helse Bergen HF, Haukeland University Hospital, Postboks 1400, NO-5021 Bergen, Norway; and Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway, Phone: +47 55973113


Received: 2019-02-23

Accepted: 2019-04-01

Published Online: 2019-05-14

Published in Print: 2019-09-25


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 10, Pages 1511–1521, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2019-0214.

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