Abstract WP255: Rapid Coagulation Tests for Acute Ischemic Stroke

Abstract

Background and objectives: The results of coagulation tests are important for the decision of thrombolysis in acute ischemic stroke patients who are taking oral anticoagulants. In coagulation tests, the preparation of blood specimens is a major bottleneck in the workflow. Clinical and Laboratory Standard Institute (CLSI) guidelines require that routine coagulation tests are performed with platelet-poor plasma (<10,000 platelets per microliter). We investigated whether high acceleration centrifugation can reduce the time of coagulation tests without breaking the guidelines. Methods: We compared the high acceleration centrifugation condition (3 minutes, 8000 rpm) with the standard centrifugation condition (15 minutes, 3000 rpm) in 32 patients. The pre- and post-centrifugation platelet counts were measured and compared between the groups. Results: Sixteen samples were centrifuged in high acceleration condition and another 16 samples in standard condition. The pre-centrifugation platelet counts were not different (median, 165,000 (interquartile range, 146,750-185,500) per microliter vs. 166,500 (128,000-193,250), p=0.675) between the groups. Although the post-centrifugation platelet counts were higher in the high acceleration group than the standard group (4,500 (2,250-6,000) vs. 1,000 (0-2,000), p<0.001), all the samples in the high acceleration group met the requirements of platelet-poor plasma. Using the high acceleration centrifugation method, the reporting time of coagulation tests decreased from 24 (23-25) to 12 (12-13.5) minutes. Conclusion: High acceleration centrifugation can reduce the time of coagulation tests for 12 minutes without breaking the guidelines. This method may help to shorten the door-to-needle time in acute ischemic stroke patients who are taking oral anticoagulants.