Pitfalls in Coagulation Testing

Abstract

Assays in the coagulation laboratory are affected by numerous variables. Variables which have impact on the test result can lead to incorrect results, and potentially to consequences for further diagnostic and therapeutic decisions made by the clinician. The interferences can be separated into three main groups: biological interferences, with an actual impairment of the patient's coagulation system (congenital or acquired); physical interferences, which usually occur in the pre-analytical phase; and chemical interferences, because of the presence of drugs (mainly anticoagulants) in the blood to be tested. This article discusses some of these interferences in seven instructive cases of (near) miss events as an approach to generate more attention to these issues.

Zusammenfassung

Gerinnungsanalysen werden durch zahlreiche Variablen beeinflusst. Variablen, die sich auf das Testergebnis auswirken, können zu falschen Ergebnissen und damit möglicherweise zu Konsequenzen für das weitere diagnostische und therapeutische Vorgehen des Klinikers führen. Diese Interferenzen lassen sich in drei Hauptgruppen einteilen: biologische Interferenzen mit einer tatsächlichen Beeinträchtigung des Gerinnungssystems des Patienten (angeboren oder erworben); physikalische Interferenzen, die in der Regel in der prä-analytischen Phase auftreten; und chemische Interferenzen aufgrund des Vorhandenseins von Arzneimitteln und Chemikalien (hauptsächlich Antikoagulanzien) im zu testenden Blut. In diesem Artikel werden einige dieser Interferenzen anhand von sieben aufschlussreichen Fällen von (Beinahe-) Fehlern erörtert, mit dem Ziel, die Aufmerksamkeit für dieses Thema zu erhöhen.

Keywords

coagulation testing - interferences - case-based learning

Schlüsselwörter

Gerinnungstests - Interferenzen - fallbasiertes Lernen

Publication History

Received: 28 October 2022

Accepted: 17 November 2022

Article published online:
20 February 2023

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