Rapid Centrifugation in the Routine Hemostasis Laboratory

Thromb Haemost. 2019 Dec;119(12):2025-2033. doi: 10.1055/s-0039-1696712. Epub 2019 Oct 10.

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.

MeSH terms

  • Blood Coagulation
  • Blood Coagulation Factors / analysis
  • Blood Coagulation Tests / methods*
  • Centrifugation / methods*
  • Centrifugation / standards*
  • Fibrinogen / analysis
  • Hemostasis*
  • Humans
  • International Normalized Ratio
  • Laboratories, Hospital
  • Partial Thromboplastin Time
  • Plasma
  • Prothrombin Time
  • Reproducibility of Results
  • Thrombin Time

Substances

  • Blood Coagulation Factors
  • Fibrinogen