Abstract
Laboratory services play an important role in optimizing patient care today, and the importance of clinical laboratories is now widely accepted in medical practice. A critical value, originally described by Lundberg more than 30 years ago, refers to an abnormal test result that can lead to a serious life threat if not reported in a timely manner. In this study, we tried to determine the importance of critical values that can lead to a serious life threat with regard to their prevalence and frequency in laboratory tests of Iranian patients. In this cross-sectional study, the frequency of critical values in laboratory tests were determined and compared according to the type of laboratory parameter, age, sex, the inpatient/outpatient status, the related clinical ward, recurrence of critical values in the patient's test results, and the sampling working shift in Shahid Bahonar hospital in Kerman, Iran, in 2017 and 2018. Among the tests, 0.2% had critical results. There was a significant relationship between the frequency of critical results with the patients' age (P = 0.002) and sex (P = 0.001) as well as with sampling working shift (P = 0.030) and admission ward (P = 0.001). Among the tests with critical values, the urea test was the most common with 32.2% critical value incidence. To maintain patient safety, proper recording of the results in laboratory tests and prompt reporting of critical values to the health care staff before repeating the test should be emphasized.
Highlights
Materials and Methods In this cross-sectional descriptive-comparative study, a total of 2146 consecutive critical values based on type of laboratory parameter, age, sex, inpatient/outpatient status, associated clinical ward, repetition of patient’s critical values, and sampling working shift were collected and compared in Shahid-Bahonar hospital in Kerman, Iran, in 2017 and 2018
The critical values were detected in 58.5%, 29.0%, and 12.5% of morning, evening, and night work shifts, respectively (P = 0.030)
In this study, there was a total of 887 602 tests, among which 2146 cases (0.2%) had critical values consisting of 1481, 91, and 574 tests in biochemistry, hematology, and microbiology assays
Summary
Laboratory assays are an important part of the health care system, with a well-established role in clinical decision-making and prognosis.[1,2,3] Critical values are very life-threatening high or low measurements in laboratory tests and should be reported promptly to the health care providers in order to develop better diagnostic and prognostic approaches and results by helping the personnel adopt better courses of action in patient treatment.[4,5,6,7,8]Labs should inform patients and physicians of critical values so as to facilitate decision making as emphasized by the Joint Commission[5] and College of American Pathologists.[9,10] The methods used for determination of critical values are not the same across the countries and ethnic groups; these measurements should be determined separately in various regions,[5,11] and periodical updates should be developed to improve the quality of the results. 2 homogenizing the results may be done to facilitate the comparison of results worldwide.[6]. We tried to determine the importance of critical values that can lead to a serious life threat with regard to their prevalence and frequency in laboratory tests of Iranian patients. Methods: In this cross-sectional study, the frequency of critical values in laboratory tests were determined and compared according to the type of laboratory parameter, age, sex, the inpatient/outpatient status, the related clinical ward, recurrence of critical values in the patient’s test results, and the sampling working shift in Shahid Bahonar hospital in Kerman, Iran, in 2017 and 2018. Arch Iran Med. 2021;24(6):473–477. doi: 10.34172/ aim.2021.68
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