The use of the hemolysis index as an indirect indicator of whole blood sample quality.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL

Diagnosis Pub Date : 2025-07-02 DOI:10.1515/dx-2025-0066

Stefano Pastori, Vincenzo Roccaforte, Rossella Panella, Erika Jani, Alberto Ponzoni, Marta Spreafico, Giuseppe Lippi, Ruggero Buonocore, Massimo Daves

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引用次数: 0

Abstract

Objectives: The aim of this study is to assess the discrepancies between potassium values obtained from point-of-care testing and laboratory analyzers, and to propose a straightforward method to indirectly assess the likelihood of hemolysis in whole blood samples.

Methods: The data were collected from 409 hospitalized patients (199 males, 210 females; median age 78 years, interquartile range 55-87) in whom were simultaneously requested the blood gas profile, including electrolytes (Na, K, Cl and Ca²⁺) on the GEM Premier 5000 blood gas analyzer and K in plasma samples on the Cobas analytical system.

Results: The Wilcoxon test showed a significant difference (p<0.0001) for K measurements, with a number of positive differences between Cobas and GEM Premier 5,000 of 110 and negative differences of 293. The median value of the hemolysis index was 7 (95 % CI for the median 6 to 8). The differences between the two K measurements obtained from plasma and whole blood samples showed a lowest and highest differences of -1.7 and 4.6 mmol/L. The median difference was 0.63 (95 % CI for the median: 0.54-0.73) and the interquartile range (IQR) was 0.48-0.9. Overall, 89 samples (21 %) displayed a difference larger than the relative change value.

Conclusions: The presence of hemolysis in plasma samples should alert laboratory professionals to carefully evaluate the corresponding whole blood results. Concordant values indicate the presence of hemolysis in the whole blood sample, while discordant values suggest that hemolysis only affects one of the two samples.

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使用溶血指数作为全血样本质量的间接指标。

目的：本研究的目的是评估从护理点测试和实验室分析仪获得的钾值之间的差异，并提出一种直接的方法来间接评估全血样本中溶血的可能性。方法：收集409例住院患者资料，其中男性199例，女性210例；中位年龄78岁，四分位数范围55-87)，他们同时被要求进行血气分析，包括GEM Premier 5000血气分析仪上的电解质（Na， K， Cl和Ca2+）和Cobas分析系统上血浆样品中的K。结论：血浆样品中溶血的存在应提醒实验室专业人员仔细评估相应的全血结果。一致性值表明整个血液样本中存在溶血，而不一致性值表明溶血只影响两个样本中的一个。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnosis MEDICINE, GENERAL & INTERNAL-

CiteScore

7.20

自引率

5.70%

发文量

期刊介绍： Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.　 Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error