PMID- 25780011
OWN - NLM
STAT- MEDLINE
DCOM- 20150603
LR  - 20191210
IS  - 1943-7722 (Electronic)
IS  - 0002-9173 (Linking)
VI  - 143
IP  - 4
DP  - 2015 Apr
TI  - Validation of hemolysis index thresholds optimizes detection of clinically 
      significant hemolysis.
PG  - 579-83
LID - 10.1309/AJCPDUDE1HRA0YMR [doi]
AB  - OBJECTIVES: Automated hemolysis index (HI) measurement has standardized the 
      identification and gradation of sample hemolysis. METHODS: This study evaluates 
      whether clinically significant changes in the concentration of intracellular 
      analytes occur at manufacturer-recommended automated HI thresholds (HI >/=3, >25 
      mg/dL hemoglobin). RESULTS: Adult outpatient results for serum potassium (K+), 
      magnesium (Mg), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) 
      were analyzed. Mean +/- SD analyte concentration and distribution within the 
      reference interval (RI) were calculated for each HI group (1-7). Potassium 
      results with an HI of 4 or more demonstrated clinically significant differences 
      (>/=0.5 mmol/L) in mean K+ concentration and RI classification compared with 
      non-hemolyzed samples (HI = 1). LDH and AST showed clinically significant 
      differences (+20%) for an HI of 3 or more. For Mg, only the group with an HI of 7 
      demonstrated a clinically significant difference (>25%); however, the number was 
      low. CONCLUSIONS: Mean measured potassium concentrations are not clinically 
      significantly affected by hemolysis at the manufacturer-recommended HI threshold, 
      while AST and LDH are. Aligning reporting of sample hemolysis with clinically 
      significant changes provides clinically meaningful alerts regarding this common 
      pre-analytic error.
CI  - Copyright(c) by the American Society for Clinical Pathology.
FAU - Goyal, Tanu
AU  - Goyal T
AD  - From the Department of Pathology, University Hospitals Case Medical Center, 
      Cleveland, OH, and.
FAU - Schmotzer, Christine L
AU  - Schmotzer CL
AD  - From the Department of Pathology, University Hospitals Case Medical Center, 
      Cleveland, OH, and Case Western Reserve University, Cleveland, OH. 
      Christine.Schmotzer@UHhospitals.org.
LA  - eng
PT  - Journal Article
PT  - Validation Study
PL  - England
TA  - Am J Clin Pathol
JT  - American journal of clinical pathology
JID - 0370470
RN  - 0 (Hemoglobins)
RN  - EC 1.1.1.27 (L-Lactate Dehydrogenase)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - I38ZP9992A (Magnesium)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Adult
MH  - Aspartate Aminotransferases/blood
MH  - Blood Chemical Analysis/instrumentation/*standards
MH  - Hemoglobins/analysis
MH  - *Hemolysis
MH  - Humans
MH  - L-Lactate Dehydrogenase/blood
MH  - Magnesium/blood
MH  - Potassium/blood
MH  - Reference Values
OTO - NOTNLM
OT  - Automated chemistry
OT  - Hemolysis
OT  - Preanalytic error
OT  - Specimen integrity
EDAT- 2015/03/18 06:00
MHDA- 2015/06/04 06:00
CRDT- 2015/03/18 06:00
PHST- 2015/03/18 06:00 [entrez]
PHST- 2015/03/18 06:00 [pubmed]
PHST- 2015/06/04 06:00 [medline]
AID - 143/4/579 [pii]
AID - 10.1309/AJCPDUDE1HRA0YMR [doi]
PST - ppublish
SO  - Am J Clin Pathol. 2015 Apr;143(4):579-83. doi: 10.1309/AJCPDUDE1HRA0YMR.