title: Reduction of preanalytical errors due to in vitro activation of coagulation.
abstract: Statistically significant errors due to activation of coagulation may result from the blood sampling procedure. In order to establish the magnitude of errors, blood sample aliquots were drawn in triplicate from one venipuncture. A procedure is described for discrimination of inappropriate analytical results in 162 subjects. Estimated percentages of insufficient duplicate results amounted to 36% for thrombin-antithrombin complexes, to 5% for prothrombin fragment 1+2, to 2% for fibrinogen degradation products and to 4% for fibrin degradation products. It is concluded that the overall reliability of results for coagulation analytes can be considerably improved by drawing blood samples in triplicate and subsequent rejection of samples with inappropriate reproducibility for thrombin-antithrombin. Routine parameters like prothrombin time or activated partial thromboplastin time in normal conditions are not susceptible for the phenomenon of coagulation activation.
authors.affiliation: Department of Clinical Chemistry, Hematology and Immunology, Medical Centre Alkmaar, The Netherlands. p.bartels@mca.alkmaar.nl
authors.forename: P C
authors.initials: PC
authors.lastname: Bartels
authors.forename: M
authors.initials: M
authors.lastname: Schoorl
authors.forename: A A
authors.initials: AA
authors.lastname: van Bodegraven
mesh_terms: D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000592:standards; D001777:Blood Coagulation; D001800:Blood Specimen Collection / Q000592:standards*; D003951:Diagnostic Errors / Q000517:prevention & control; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D015233:Models, Statistical; D015999:Multivariate Analysis; D010446:Peptide Fragments / Q000097:blood; D010447:Peptide Hydrolases / Q000097:blood; D011516:Prothrombin; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases