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Stability of 35 biochemical and immunological routine tests after 10 hours storage and transport of human whole blood at 21°C.

Henriksen LO, Faber NR, Moller MF, Nexo E, Hansen AB - Scand. J. Clin. Lab. Invest. (2014)

Bottom Line: We observed no statistically significant bias and results within the goal for imprecision between baseline samples and 10-h samples for albumin, alkaline phosphatase, antitrypsin, bilirubin, creatinine, free triiodothyronine, γ-glutamyl transferase, haptoglobin, immunoglobulin G, lactate dehydrogenase, prostate specific antigen, total carbon dioxide, and urea.Alanine aminotransferase, amylase, C-reactive protein, calcium, cholesterol, creatine kinase, ferritin, free thyroxine, immunoglobulin A, immunoglobulin M, orosomucoid, sodium, transferrin, and triglycerides met goals for imprecision, though they showed a minor, but statistically significant bias in results after storage.We conclude that whole blood in lithium-heparin or serum tubes stored for 10 h at 21 ± 1°C, may be used for routine analysis without restrictions for all investigated analytes but folate and phosphate.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Biochemistry, Regional Hospital West Jutland , Herning and Holstebro , Denmark.

ABSTRACT

Background: Suitable procedures for transport of blood samples from general practitioners to hospital laboratories are requested. Here we explore routine testing on samples stored and transported as whole blood in lithium-heparin or serum tubes.

Methods: Blood samples were collected from 106 hospitalized patients, and analyzed on Architect c8000 or Advia Centaur XP for 35 analytes at base line, and after storage and transport of whole blood in lithium-heparin or serum tubes at 21 ± 1°C for 10 h. Bias and imprecision (representing variation from analysis and storage) were calculated from values at baseline and after storage, and differences tested by paired t-tests. Results were compared to goals set by the laboratory.

Results: We observed no statistically significant bias and results within the goal for imprecision between baseline samples and 10-h samples for albumin, alkaline phosphatase, antitrypsin, bilirubin, creatinine, free triiodothyronine, γ-glutamyl transferase, haptoglobin, immunoglobulin G, lactate dehydrogenase, prostate specific antigen, total carbon dioxide, and urea. Alanine aminotransferase, amylase, C-reactive protein, calcium, cholesterol, creatine kinase, ferritin, free thyroxine, immunoglobulin A, immunoglobulin M, orosomucoid, sodium, transferrin, and triglycerides met goals for imprecision, though they showed a minor, but statistically significant bias in results after storage. Cobalamin, folate, HDL-cholesterol, iron, phosphate, potassium, thyroid stimulating hormone and urate warranted concern, but only folate and phosphate showed deviations of clinical importance.

Conclusions: We conclude that whole blood in lithium-heparin or serum tubes stored for 10 h at 21 ± 1°C, may be used for routine analysis without restrictions for all investigated analytes but folate and phosphate.

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Imprecision and bias calculated for results obtained at baseline and after 10 h of storage of whole blood (in lithium-heparin or serum tubes). Data on imprecision (A) shows CV calculated from results obtained at baseline and after storage of whole blood in lithium-heparin or serum tubes at 21°C for 10 h. The analytical imprecision is indicated as grey columns and the goal imprecision as the total height of the columns. Data on bias (B) shows the mean bias between baseline and results obtained after storage of whole blood for 10 h. The columns indicate bias goal. Data for analytical- and goal-CV as well as bias goal are indicated for each analyte in Table II.
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Figure 1: Imprecision and bias calculated for results obtained at baseline and after 10 h of storage of whole blood (in lithium-heparin or serum tubes). Data on imprecision (A) shows CV calculated from results obtained at baseline and after storage of whole blood in lithium-heparin or serum tubes at 21°C for 10 h. The analytical imprecision is indicated as grey columns and the goal imprecision as the total height of the columns. Data on bias (B) shows the mean bias between baseline and results obtained after storage of whole blood for 10 h. The columns indicate bias goal. Data for analytical- and goal-CV as well as bias goal are indicated for each analyte in Table II.

Mentions: Thirteen of the analytes showed no statistically significant bias and mean CVs below or close to the analytical CV upon storage of whole blood for 10 h (ALB, ATRYP, BASP, BILI, CO2, CREA, F-T3, GGT, HAPT, IgG, LD, PSA, UREA), and thus will not be subject to any further discussion (Figure 1 and Table II). For most of the remaining analytes bias was statistically significant though quantitatively small (ALAT, AMYL, CA, CHOL, CK, CRP, F-T4, FER, IgA, IgM, K, Na, OROS, TGLY, TRANS and URATE). A more pronounced bias was observed for B12, Fe, FOL, HDL-C and TSH. Bias exceeding the bias goal was observed only for P (Figure 1 and Table II) and the 95% confidence interval (95% CI) of bias was below the bias goal for all but CRP, FT-4, HDL-C, K and TSH. Despite the changes in bias all but three analytes (FOL, K and P) met the criteria set forward for imprecision – the goal-CV (Figure 1 and Table II).


Stability of 35 biochemical and immunological routine tests after 10 hours storage and transport of human whole blood at 21°C.

Henriksen LO, Faber NR, Moller MF, Nexo E, Hansen AB - Scand. J. Clin. Lab. Invest. (2014)

Imprecision and bias calculated for results obtained at baseline and after 10 h of storage of whole blood (in lithium-heparin or serum tubes). Data on imprecision (A) shows CV calculated from results obtained at baseline and after storage of whole blood in lithium-heparin or serum tubes at 21°C for 10 h. The analytical imprecision is indicated as grey columns and the goal imprecision as the total height of the columns. Data on bias (B) shows the mean bias between baseline and results obtained after storage of whole blood for 10 h. The columns indicate bias goal. Data for analytical- and goal-CV as well as bias goal are indicated for each analyte in Table II.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219582&req=5

Figure 1: Imprecision and bias calculated for results obtained at baseline and after 10 h of storage of whole blood (in lithium-heparin or serum tubes). Data on imprecision (A) shows CV calculated from results obtained at baseline and after storage of whole blood in lithium-heparin or serum tubes at 21°C for 10 h. The analytical imprecision is indicated as grey columns and the goal imprecision as the total height of the columns. Data on bias (B) shows the mean bias between baseline and results obtained after storage of whole blood for 10 h. The columns indicate bias goal. Data for analytical- and goal-CV as well as bias goal are indicated for each analyte in Table II.
Mentions: Thirteen of the analytes showed no statistically significant bias and mean CVs below or close to the analytical CV upon storage of whole blood for 10 h (ALB, ATRYP, BASP, BILI, CO2, CREA, F-T3, GGT, HAPT, IgG, LD, PSA, UREA), and thus will not be subject to any further discussion (Figure 1 and Table II). For most of the remaining analytes bias was statistically significant though quantitatively small (ALAT, AMYL, CA, CHOL, CK, CRP, F-T4, FER, IgA, IgM, K, Na, OROS, TGLY, TRANS and URATE). A more pronounced bias was observed for B12, Fe, FOL, HDL-C and TSH. Bias exceeding the bias goal was observed only for P (Figure 1 and Table II) and the 95% confidence interval (95% CI) of bias was below the bias goal for all but CRP, FT-4, HDL-C, K and TSH. Despite the changes in bias all but three analytes (FOL, K and P) met the criteria set forward for imprecision – the goal-CV (Figure 1 and Table II).

Bottom Line: We observed no statistically significant bias and results within the goal for imprecision between baseline samples and 10-h samples for albumin, alkaline phosphatase, antitrypsin, bilirubin, creatinine, free triiodothyronine, γ-glutamyl transferase, haptoglobin, immunoglobulin G, lactate dehydrogenase, prostate specific antigen, total carbon dioxide, and urea.Alanine aminotransferase, amylase, C-reactive protein, calcium, cholesterol, creatine kinase, ferritin, free thyroxine, immunoglobulin A, immunoglobulin M, orosomucoid, sodium, transferrin, and triglycerides met goals for imprecision, though they showed a minor, but statistically significant bias in results after storage.We conclude that whole blood in lithium-heparin or serum tubes stored for 10 h at 21 ± 1°C, may be used for routine analysis without restrictions for all investigated analytes but folate and phosphate.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Biochemistry, Regional Hospital West Jutland , Herning and Holstebro , Denmark.

ABSTRACT

Background: Suitable procedures for transport of blood samples from general practitioners to hospital laboratories are requested. Here we explore routine testing on samples stored and transported as whole blood in lithium-heparin or serum tubes.

Methods: Blood samples were collected from 106 hospitalized patients, and analyzed on Architect c8000 or Advia Centaur XP for 35 analytes at base line, and after storage and transport of whole blood in lithium-heparin or serum tubes at 21 ± 1°C for 10 h. Bias and imprecision (representing variation from analysis and storage) were calculated from values at baseline and after storage, and differences tested by paired t-tests. Results were compared to goals set by the laboratory.

Results: We observed no statistically significant bias and results within the goal for imprecision between baseline samples and 10-h samples for albumin, alkaline phosphatase, antitrypsin, bilirubin, creatinine, free triiodothyronine, γ-glutamyl transferase, haptoglobin, immunoglobulin G, lactate dehydrogenase, prostate specific antigen, total carbon dioxide, and urea. Alanine aminotransferase, amylase, C-reactive protein, calcium, cholesterol, creatine kinase, ferritin, free thyroxine, immunoglobulin A, immunoglobulin M, orosomucoid, sodium, transferrin, and triglycerides met goals for imprecision, though they showed a minor, but statistically significant bias in results after storage. Cobalamin, folate, HDL-cholesterol, iron, phosphate, potassium, thyroid stimulating hormone and urate warranted concern, but only folate and phosphate showed deviations of clinical importance.

Conclusions: We conclude that whole blood in lithium-heparin or serum tubes stored for 10 h at 21 ± 1°C, may be used for routine analysis without restrictions for all investigated analytes but folate and phosphate.

Show MeSH
Related in: MedlinePlus