Is it acceptable to use coagulation plasma samples stored at room temperature and 4°C for 24 hours for additional prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin, and D-dimer testing?

2017 ◽  
Vol 39 (5) ◽  
pp. 475-481 ◽  
Author(s):  
V. Rimac ◽  
D. Coen Herak
Author(s):  
Ralf Junker ◽  
Margit Käse ◽  
Helmut Schulte ◽  
Ruth Bäumer ◽  
Claus Langer ◽  
...  

AbstractThe Dade Behring BCS is a coagulation analyser with optical reaction detection (standard 405nm). The present study was conducted to evaluate measurement at 570nm for analyses in interfering plasma samples. Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer in normal (n=50), lipaemic (n=60), icteric (n=113), and haemolytic (n=58) samples were measured at 405 and 570nm. As they are unaffected by the optical properties of the sample, the mechanical STAcompact analyser (Roche Diagnostics) and an ELISA technique were defined as the “comparison” methods. The percentage of valid PT results using the 570-nm method varied from 54% (lipaemic samples) to 97% (haemolytic samples). Valid aPTT measurements were found in 67% (lipaemic samples) up to 93% (icteric samples) of samples. Fibrinogen measurement revealed valid results in 58% (lipaemic samples) to 100% (haemolytic samples) of samples. The number of valid D-dimer results varied from 28% (lipaemic material) up to 100% (haemolytic material). Significant inter-method differences were found: aPTT in lipaemic (BCS 405 vs. 570nm) and icteric samples (STAcompact vs. BCS 405 and 570nm); fibrinogen in lipaemic (BCS 405 vs. 570nm), icteric (BCS 405 vs. 570nm; STAcompact vs. BCS 570nm) and haemolytic samples (STAcompact vs. BCS 405 and 570nm). Differences between the BCS 570-nm and the STAcompact methods were in most cases low and less pronounced than between the BCS 570- and 405-nm methods, making the BCS 570-nm method an alternative to measurement at 405nm. Limitations have to be taken into account regarding lipaemic plasma.


2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5248-5248
Author(s):  
Bhaumik Arvindkumar Shah ◽  
Arulselvi Subramanium ◽  
Subhadra Sharma ◽  
Deepak Agrawal ◽  
Gaurav Chhabra ◽  
...  

Abstract Abstract 5248 In India trauma related deaths occur every 1.9 minutes. Mortality in severe traumatic injury (ISS>16) is six times higher in developing country like India. Coagulopathy is observed in almost 25– 30% of trauma patients which itself is an independent risk factor for haemorrhage. Coagulopathy detected early after injury is indicative of injury severity and itself is a prognostic factor for mortality. Aim To find out the usefulness of thromboelastography (TEG) in detecting coagulopathy in contrast to conventional methods of plasma based standard coagulation parameters (PT, aPTT, TT, fibrinogen, D-dimer) Objective To detect coagulopathy early by TEG in trauma patients within 24 hrs after injury which can be useful to guide haemostatic therapies to reduce mortality. Materials and methods Patients admitted to trauma casualty were studied within 24 hrs after injury. Native whole blood was withdrawn through venepuncture appropriately in syringe using 21G needle and TEG was performed within 2 mins. Blood was also collected in citrated tube to assess standard coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer) and also by means of thromboelastography. Results Patients (n=87,New ISS-24.78(mean)) admitted to J.P.N Apex trauma centre casualty from 1st April,2011 to 31st July,2011 were studied. The cases included in the study were isolated head injury (n=40, NISS-25.87(mean)), multiple trauma with head injury (n=13,NISS – 30.69 (mean)) and trauma other than head injury (n=34, NISS-21.24 (mean)).Thromboelastography was performed using whole blood (n=69) and citrated blood (n=18). Coagulation tests were performed on all 87 patients using both TEG and conventional coagulation parameters. Total 52 patients showed coagulopathy by TEG and only 14 patients showed coagulopathy by standard coagulation parameters (prothrombin time, activated partial thromboplastin time). Only in 10 cases coagulopathy was detected by both methods. 4 patients showed coagulopathy only by conventional methods while 42 patients showed coagulopathy by only Thromboelastography (TEG). To find out whether there is any stastistical significance in the observed apparently better result by TEG, McNemar Test was carried out and P value was <0.0001. Conclusion Thromboelastography could be a better technique as compared to conventional measurements of PT, aPTT, TT, Fibrinogen, D-dimer in early detection of coagulopathy in trauma patients. Disclosures: No relevant conflicts of interest to declare.


Author(s):  
Among Wibowo ◽  
Tiara Aninditha ◽  
Henry Riyanto Sofyan ◽  
Rini Andriani

EFFECT OF HYPERCOAGULABILITY TO ASTROCYTOMA MORTALITY WITHIN 12-MONTHS OF FOLLOW UPABSTRACTIntroduction: Astrocytoma is the most common primary brain tumor. Hypercoagulable state is one of brain tumor complications which can cause vein thromboembolism (VTE). Vein thromboembolism incidence is increased in astrocytoma patients. Hypercoagulable state in astrocytoma could lower patient’s survival.Aim: To investigate the effect of hypercoagulable state on mortality within 12 months of follow up in astrocytoma patients.Methods: This study design was retrospective cohort. This research data was taken from medical records in Cipto Mangunkusumo General Hospital and Dharmais Cancer Center Hospital on December 2017-February 2018. The subjects were adult astrocytoma patients who had histopathology and hemostasis examination. The variables investigated in this study were gender, age, prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer. Data processed descriptively and analytically using SPSS ver. 20 for Windows.Results: There were 49 subjects in this research. Around 30 (61.2%) subjects were men and 20 (40.8%) subjects aged >50 years old. High grade glioma was found in 39 (79.6%) subjects and hypercoagulable state was found in 34 (69.4%) subjects. There were 20 subjects deceased in 12-month follow-up. Subjects with hypercoagulable state had relative risk (RR) of 3.97 more susceptible to die in 12-month follow-up compared to control (p=0.009).Discussion: Hypercoagulation was a mortality risk factor in 12-month follow-up in patients with astrocytoma.Keywords: Astrocytoma, hypercoagulation, mortality within 12-months of follow upABSTRAKPendahuluan: Astrositoma merupakan tumor otak primer yang paling sering ditemukan. Salah satu komplikasi dari tumor otak adalah keadaan hiperkoagulasi. Keadaan hiperkoagulasi dapat menyebabkan tromboemboli vena. Insiden tromboemboli vena meningkat pada astrositoma. Keadaan hiperkoagulasi pada astrositoma dapat menurunkan kesintasan atau meningkatkan mortalitas pada pasien astrositoma.Tujuan: Mengetahui pengaruh hiperkoagulasi pada mortalitas pasien astrositoma dalam 12 bulan pemantauan.Metode: Penelitian kohort retrospektif terhadap pasien tumor otak jenis astrositoma yang dirawat oleh Divisi Neuroonkologi di RSUPN Dr. Cipto Mangunkusumo (RSCM) dan RS Pusat Kanker Dharmais (RSKD) pada bulan Desember 2017 hingga Februari 2018. Sumber data adalah data sekunder berupa rekam medis pasien dewasa yang telah memiliki hasil pemeriksaan histopatologis dan hemostasis. Variabel yang diambil dalam penelitian ini adalah jenis kelamin, usia, prothrombin time (PT), activated partial thromboplastin time (aPTT), dan D-dimer. Data diolah secara deskriptif dan analitik bivariat menggunakan SPSS ver. 20 for Windows.Hasil: Terdapat 49 subjek dalam penelitian ini yang mayoritas (61,2%) laki-laki, berusia <50 tahun (59,2%), dan memiliki jenis high grade gliomas (75,8%). Sebagian besar subjek mengalami hiperkoagulasi (69,4%) dan dalam kondisi hidup (59,2%) pada 12 bulan pascaperawatan. Subjek dengan hiperkoagulasi memiliki risiko relatif (RR) 3,97 kali lebih rentan mengalami kematian setelah 12 bulan dibandingkan kontrol (p=0,009).Diskusi: Hiperkoagulasi merupakan salah satu faktor risiko kematian dalam 12 bulan pada pasien astrositoma.Kata kunci: Astrositoma, hiperkoagulasi, mortalitas 12 bulan


2019 ◽  
Vol 20 (4) ◽  
pp. 327-331
Author(s):  
Moutinho Beatriz ◽  
Pinto Beatriz ◽  
Cardoso Rita ◽  
Alves Helena ◽  
Botelho Monica

Background: Clinical analysis often involves clotting assays. Although the guidelines suggest the storing and freezing of samples before these assays, there are contradictory results in the literature. The objective of this study was to analyse the effect of the temperature and the storage of plasma sample on Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT) in clinical samples for 65 patients without coagulation disorders. Materials and Methods: After centrifugation, plasma of each patient was tested at arrival as part of their routine care and separately aliquoted. Three aliquots were stored at room temperature, 4°C and - 20°C for 24h after collection, two aliquots were stored at 4°C and -20°C for 1 week and one aliquot was stored at -70°C for 1 month. Results: PT from healthy patients was affected at room temperature for 24h and at 4°C for 1 week. For aPTT, the results were statistically different for all the conditions after 24h and at 4°C for 1 week. Conclusion: Results indicate that PT and aPTT can be stored at -70ºC for at least 1 month without any significant changes in the assay result.


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