دورية أكاديمية

Hemolysis Index and Potassium Reporting.

التفاصيل البيبلوغرافية
العنوان: Hemolysis Index and Potassium Reporting.
المؤلفون: DiToro DF; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Conrad MJ; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA., Jarolim P; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
المصدر: American journal of clinical pathology [Am J Clin Pathol] 2022 Jun 07; Vol. 157 (6), pp. 809-813.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 0370470 Publication Model: Print Cited Medium: Internet ISSN: 1943-7722 (Electronic) Linking ISSN: 00029173 NLM ISO Abbreviation: Am J Clin Pathol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2016- : Oxford : Oxford University Press
Original Publication: Philadelphia [etc.] Lippincott [etc.]
مواضيع طبية MeSH: Hemolysis* , Potassium*, Hematologic Tests ; Humans ; Infant, Newborn ; Laboratories
مستخلص: Objectives: In vitro hemolysis generates a spurious increase in potassium. Roche Diagnostics recently revised its recommended guidelines for potassium reporting on cobas analyzers. By dramatically reducing the allowable degree of hemolysis, these guidelines would increase specimen rejection rates. We attempted to balance the desire to avoid inaccurate results with the clinical implications of increased specimen rejection rates.
Methods: We downloaded hemolytic indices (HI) for 80,795 specimens tested at our institution on cobas chemistry analyzers in 1 month and evaluated potential specimen rejection rates based on the new criteria. We also spiked nonhemolyzed samples with hemolyzed blood to assess the influence of HI values on potassium measurements.
Results: The new recommendations would lead to specimen rejection rates of 76% in the neonatal intensive care unit (NICU), 41% in the emergency department (ED), 16% in inpatient specimens, and 9% in outpatient samples. Our current criteria of reporting potassium concentrations in inpatient and outpatient specimens with HI ≤100 and in NICU and ED specimens with HI ≤300 and additional interpretive guidance for HI values between 100 and 300 reduce unnecessary specimen rejections to 3% in NICU, 2% in ED and inpatients, and less than 1% in outpatients without significantly increasing the number of clinically consequential incorrect results.
Conclusions: The new recommendations would lead to unacceptably high specimen rejection rates. Laboratories should develop context-specific, evidence-based reporting criteria that minimize reporting of inaccurate results without disrupting delivery of care.
(© The Author(s) 2022. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
فهرسة مساهمة: Keywords: Guidelines; Hemolytic index; Potassium; Reporting
المشرفين على المادة: RWP5GA015D (Potassium)
تواريخ الأحداث: Date Created: 20220117 Date Completed: 20220608 Latest Revision: 20220712
رمز التحديث: 20221213
DOI: 10.1093/ajcp/aqab217
PMID: 35038719
قاعدة البيانات: MEDLINE
الوصف
تدمد:1943-7722
DOI:10.1093/ajcp/aqab217