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CC BY-NC-ND 4.0 · Thromb Haemost 2019; 119(12): 2025-2033
DOI: 10.1055/s-0039-1696712
New Technologies, Diagnostic Tools and Drugs
Georg Thieme Verlag KG Stuttgart · New York

Rapid Centrifugation in the Routine Hemostasis Laboratory

Nathan Wolfensberger‡   *
1   Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
,
Georgios Georgiou‡   *
2   Unilabs Lausanne, Lausanne, Switzerland
,
Evelyne Giabbani
3   Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
Marianne Reusser
3   Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
Linet M. Njue
3   Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
Martin Fiedler
4   University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
Alexander B. Leichtle
4   University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
5   Insel Data Science Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
Michael Nagler
3   Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
4   University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Publikationsverlauf

14. Juni 2019

21. Juli 2019

Publikationsdatum:
10. Oktober 2019 (online)

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Abstract

Background The use of short and uniform centrifugation schemes contributes significantly to the successful automation of laboratory procedures. It is however unclear if this is applicable to the hemostasis laboratory.

Objectives This article assesses the accuracy of measurements obtained with a rapid, high-speed centrifugation scheme in a large set of hemostasis tests, covering the full spectrum of values obtained in clinical practice, and using meaningful statistical measures.

Methods Two citrated plasma samples were obtained from consecutive patients of a tertiary hospital with suspected abnormal hemostasis tests and processed with two centrifugation schemes in parallel: 1,500 × g for 10 minutes and 3,137 × g for 7 minutes. The following tests were conducted: prothrombin time (n = 125), international normalized ratio (n = 146), activated partial thromboplastin time (n = 119), thrombin time (n = 105), fibrinogen (n = 125), factor (F)II (n = 69), FV (n = 64), FVII (n = 64), FX (n = 67), FVIII (n = 55), FIX (n = 37), FXI (n = 35), and FXIII (n = 20), D-dimer (n = 34), antithrombin (n = 31), anti-Xa activity (n = 30), von Willebrand antigen (n = 25), and von Willebrand activity (VWF:GPIbM; n = 27).

Results A wide range of results were obtained in all tests. Spearman's rank correlation coefficient was at least 0.95 for all tests except FV, FIX, and FXI. The coverage probability π at a given deviation index κ of 15% was above 0.9 for all tests except FV, FVII, FX, FVIII, FIX, FXI, and VWF:GPIbM, suggesting a lack of agreement.

Conclusion Our results suggest that high-speed centrifugation is applicable to the majority of routine hemostasis parameters. The coverage probability was more sensitive than Spearman's rank correlation to detect disagreement among centrifugation schemes.

Keywords

centrifugation - automation - laboratory/instrumentation - laboratory/methods - laboratory/standards - blood coagulation tests

Authors' Contributions

N.W. contributed to study design, reviewed the analysis, and wrote the manuscript. G.G. contributed to study design and collected the data. E.G., M.R., and L.M.N. collected data. M.F. contributed to study design and provided the devices and reagents. A.B.L. contributed to study design and analysis plan and conducted the analysis. M.N. designed the study, collected data, conducted the analysis, and wrote the manuscript. All authors intellectually reviewed the manuscript.


* These authors contributed equally to this study.


Supplementary Material