Effects of haemolysis, icterus and lipaemia on coagulation tests as performed on Stago STA‐Compact‐Max analyser
Open accessAbstract
INTRODUCTION: Haemolysis, icterus and lipaemia (HIL) may affect haemostasis test results. This may be influenced by the level of interfering substance and the reagents and end-point detection system used. METHODS: We assessed the influence of HIL on prothrombin time, activated partial thromboplastin time and fibrinogen assay using a viscosity-based detection analyser. RESULTS: Spontaneous haemolysis that occurred during sample collection and processing had no effect on PT with either a rabbit tissue factor extract or recombinant human tissue factor reagents. In contrast, addition of mechanically haemolysed cells impacted on PT for the highest haemoglobin concentration. For APTTs determined with STA®-Cephascreen® reagent, there was no significant difference between results in haemolysed and nonhaemolysed samples. For the other two reagents studied, APTTs were statistically significantly shorter in haemolysed samples compared with nonhaemolysed samples. This bias was clinically significant only for STA®-PTT Automate. For all three APTT reagents, the impact of haemolysis was sufficient to impact patient management decisions, and in some samples, the effects of lipaemia and icterus were not clinically significant. CONCLUSION: Overall, our results confirm that PT and fibrinogen were not clinically significantly affected by HIL. The APTTs of some haemolysed samples were falsely normal. Haemolysed samples for APTT determination should be rejected.
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Hemolysis, icterus, and lipemia mainly affect the APTT and can produce a falsely normal APTT in hemolyzed samples.
“Hemolysis, icterus, and lipemia mainly affects the APTT, resulting in a falsely normal APTT in hemolyzed samples.[29][30][31]”
From Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis (2020) · cites this paper as [29]
The Abstract and Conclusion report that some haemolysed samples had falsely normal APTTs, while PT and fibrinogen were not clinically significantly affected by HIL. But the Discussion says icterus and lipaemia did not produce clinically relevant APTT bias with this analyser, so the claim overstates their effect on APTT. (LLM, conf=0.88)
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Cites
Bonini, P., Plebani, M., Ceriotti, F., & Rubboli, F. (2002) · Clinical Chemistry · doi:10.1093/clinchem/48.5.691 · Cited by 850 · see citing works
Preanalytical variability: the dark side of the moon in laboratory testing
Lippi, G., Guidi, G. C., Mattiuzzi, C., & Plebani, M. (2006) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2006.073 · Cited by 416 · see citing works
Mechanisms of hemolysis‐associated platelet activation
Helms, C. C., Marvel, M., Zhao, W., Stahle, M. C., Vest, R., Kato, G. J., Lee, J. S., Christ, G. J., Gladwin, M. T., Hantgan, R. R., et al. (2013) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.12422 · Cited by 185 · see citing works
Interference in Coagulation Testing: Focus on Spurious Hemolysis, Icterus, and Lipemia
Plebani, M., Favaloro, E. J., & Lippi, G. (2012) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0032-1328972 · Cited by 131 · see citing works
Prevalence and type of pre-analytical problems for inpatients samples in coagulation laboratory.
Salvagno, G., Lippi, G., Bassi, A., Poli, G., & Guidi, G. (2008) · Journal of Evaluation In Clinical Practice · doi:10.1111/j.1365-2753.2007.00875.x · Cited by 85 · see citing works
Test result variation and the quality of evidence-based clinical guidelines
Fraser, C. G. (2004) · Clinica Chimica Acta · doi:10.1016/j.cccn.2003.12.032 · Cited by 72 · see citing works
The Effect of Specimen Hemolysis on Coagulation Test Results
Laga, A. C., Cheves, T. A., & Sweeney, J. D. (2006) · American Journal of Clinical Pathology · doi:10.1309/03fk-3378-ytra-1frf · Cited by 71 · see citing works
Grafmeyer, D., Bondon, M., Manchon, M., & Levillain, P. (1995) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.1995.33.1.31 · Cited by 59 · see citing works
The Effect of Specimen Hemolysis on Coagulation Test Results
Laga, A. C., Cheves, T. A., & Sweeney, J. D. (2006) · American Journal of Clinical Pathology · doi:10.1309/03fk3378ytra1frf · Cited by 55 · see citing works
Lippi, G., Ippolito, L., & Favaloro, E. J. (2013) · SLAS TECHNOLOGY · doi:10.1177/2211068213491747 · Cited by 41 · see citing works
Chen, Q., Shou, W., Wu, W., Guo, Y., Zhang, Y., Huang, C., & Cui, W. (2015) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0034-1543994 · Cited by 29 · see citing works
Influence of mechanical hemolysis of blood on two D-dimer immunoassays
Lippi, G., Avanzini, P., Zobbi, V., et al. (2012) · Blood Coagulation & Fibrinolysis · doi:10.1097/mbc.0b013e3283549696 · Cited by 27 · see citing works
Dot, D., Miró, J., & Fuentes‐Arderiu, X. (1992) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456329202900409 · Cited by 25 · see citing works
D’Angelo, G., de Villa, C., Tamborini, A., et al. (2015) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.12417 · Cited by 21 · see citing works
Tekkeşin, N., & Kılınç, C. (2012) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.21497 · Cited by 19 · see citing works
Tantanate, C., Teyateeti, M., & Tientadakul, P. (2020) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Clinical and Laboratory Standards institute (CLSI). Collection, Transport, and Process- ing of Blood specimen for Testing Plasma- Based Coagulation Assays and Molecular Hemostasis Assays: Approved Guideline - Fifth Edition. CLSI: document H21-A5.
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Sorted by citations
Devreese, K. M. J., de Groot, P. G., de Laat, B., Erkan, D., Favaloro, E. J., Mackie, I., Martinuzzo, M., Ortel, T. L., Pengo, V., Rand, J. H., et al. (2020) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.15047 · Cited by 439 · see citing works
Florin, L., Oyaert, M., Van Maerken, T., & Devreese, K. M. J. (2018) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.12871 · Cited by 11 · see citing works
Viewpoint: Lupus anticoagulant detection and interpretation in antiphospholipid syndrome
Efthymiou, M., Bertolaccini, M. L., & Cohen, H. (2024) · Rheumatology · doi:10.1093/rheumatology/kead623 · Cited by 5 · see citing works
- Authors
- Woolley, A., Golmard, J. ‐., & Kitchen, S.
- Affiliations
- Sheffield Teaching Hospitals NHS Foundation Trust (GB)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Kitchen, S.
- ORCID
- Kitchen, S.
- Venue
- International Journal of Laboratory Hematology
- Publisher
- Wiley
- Published
- 2016-06-16
- Volume
- 38
- Issue
- 4
- Pages
- 375-388
- ISSN
- 1751-5521 (ISSN-L)
- 1751-553X
- OpenAlex
- W2437080488
- Cited by
- 47
- References
- 16
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 9 · 2018: 2 · 2017: 3
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Laboratory Hematology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Diagnostica Stago
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
- Keywords
- hemolysis, icterus, lipemia, coagulation test interference, prothrombin time, activated partial thromboplastin time, fibrinogen assay, sample rejection
- MeSH terms
- Animals, Blood Coagulation Tests, False Negative Reactions, Hemolysis, Humans, Hyperlipidemias, Indicators and Reagents, Jaundice, Rabbits
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