Scoring system for detecting spurious hemolysis in anticoagulated blood specimens.
BACKGROUND
The identification of in vitro hemolysis (IVH) using a hematology analyzer is challenging because centrifugation of the specimens cannot be performed for cell counts. In the present study, we aimed to develop a scoring system to help identify the presence of hemolysis in anticoagulated blood specimens.


METHODS
Thirty-seven potassium EDTA anticoagulated blood specimens were obtained, and each specimen was divided into 3 aliquots (A, B, and C). Aliquots B and C were mechanically hemolyzed by aspirating 2 and 5 times, respectively, using a 27-gauge needle and then tested; aliquot A was analyzed immediately without any hemolysis. After the cells were counted, aliquots B and C were centrifuged and the supernatants were tested for the hemolytic index and lactate dehydrogenase levels.


RESULTS
The 4 hematologic parameters were selected and scored from 0 to 3 as follows:< 34.0, 34.0-36.2, 36.3-38.4, and ≥38.5 for mean cell hemoglobin concentration (MCHC, g/dL); <0.02, 0.02, 0.03, and ≥0.04 for red blood cell ghosts (10(12)/L); <0.13, 0.13-0.38, 0.39-1.30, and ≥1.31 for difference value (g/dL) of measured hemoglobin and calculated hemoglobin; and <0.26, 0.26-0.95, 0.96-3.34, and ≥3.35 for difference value (g/dL) of MCHC and cell hemoglobin concentration mean. The hemolysis score was calculated by adding all the scores from the 4 parameters. At the cutoff hemolysis score of 3, the IVH of aliquots B and C were detected as 64.9% and 91.9%, respectively.


CONCLUSIONS
The scoring system might provide effective screening for detecting spurious IVH.
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Gilsung
G
Yoo
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Juwon
J
Kim
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Young
Y
Uh
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Kwang Ro
KR
Yoon
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Soon Deok
SD
Park
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Kap Jun
KJ
Yoon
D000925:Anticoagulants / Q000494:pharmacology*; D001800:Blood Specimen Collection; D004492:Edetic Acid / Q000494:pharmacology; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis / Q000187:drug effects; D006801:Humans
D000925:Anticoagulants; D006454:Hemoglobins; D004492:Edetic Acid
Analyzer; Anticoagulants; Hemolysis; Score; System