The evaluation of hemolysis index thresholds for significant hemolysis interference on routine biochemistry analytes / Rutin biyokimya testlerine hemolizin anlamlı interferansının tespiti için hemoliz indeksi eşik değerlerinin belirlenmesi

Abstract

Abstract Objective: The hemolysis index (HI) is an objective, easy and inexpensive method for detection hemolysis. However, the clinical laboratories fully rely on the manufacturers of analytical systems for test-specific the HI thresholds at which the hemolysis significantly interferes with the analyte. In the present study, it was aimed to determine test-specific the HI thresholds for significant interference in hemolyzed specimens produced by shearing method that closely mimics actual hemolysis occurs during blood collection. Methods: Whole anticoagulated bloods obtained from 34 healthy volunteers were repeatedly passed through a blood collection needle to produce hemolysis. 29 routine biochemistry analytes were assayed on the Roche Cobas 6000 c501 analyzer. Results: The bias values determined for antistreptolysin- O, total bilirubin, chloride, C-reactive protein, gamma- glutamyltransferase, glucose, high-density lipoprotein, urea and uric acid did not achieve the allowable total error, even at the highest HI value (1550). In contrast to, HI thresholds for aspartate aminotransferase, direct bilirubin, lactate dehydrogenase, and potassium were observed as 50. Our data were generally in good agreement with what gave the list of test-specific HI thresholds by the manufacturer. However, some assays including magnesium, total protein, rheumatoid factor, and sodium had lower the HI thresholds than those of recommended by the manufacturer. Conclusion: We concluded that hemolysis is differently influence routine biochemistry tests and the HI can provide a data of which analyte is to be affected. The analyte-dependent rejection according to the HI thresholds may prevent prolongation of turnaround time for analyte unaffected by hemolysis.In addition, it was concluded that the HI thresholds might be different according to tolerable error limits selected to determine significant interference. Therefore, before the HI thresholds recommended by manufacturer is applied in laboratory, it should be noted the total allowable error limits used by manufacturer during determination of HI thresholds.