Validation of hemolysis index thresholds optimizes detection of clinically significant hemolysis

American Journal of Clinical Pathology
Tanu Goyal, Christine L Schmotzer

Abstract

Automated hemolysis index (HI) measurement has standardized the identification and gradation of sample hemolysis. This study evaluates whether clinically significant changes in the concentration of intracellular analytes occur at manufacturer-recommended automated HI thresholds (HI ≥3, >25 mg/dL hemoglobin). Adult outpatient results for serum potassium (K+), magnesium (Mg), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) were analyzed. Mean ± SD analyte concentration and distribution within the reference interval (RI) were calculated for each HI group (1-7). Potassium results with an HI of 4 or more demonstrated clinically significant differences (≥0.5 mmol/L) in mean K+ concentration and RI classification compared with non-hemolyzed samples (HI = 1). LDH and AST showed clinically significant differences (+20%) for an HI of 3 or more. For Mg, only the group with an HI of 7 demonstrated a clinically significant difference (>25%); however, the number was low. Mean measured potassium concentrations are not clinically significantly affected by hemolysis at the manufacturer-recommended HI threshold, while AST and LDH are. Aligning reporting of sample hemolysis with clinically significant changes provides clinically...Continue Reading

References

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Citations

Oct 29, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Sara PasqualettiMauro Panteghini
Jan 27, 2018·Clinical Chemistry and Laboratory Medicine : CCLM·Giuseppe LippiUNKNOWN European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)
Feb 20, 2019·Journal of Clinical Laboratory Analysis·Zhenhua DuYing Jin
Mar 28, 2019·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Hildegunn Norbakken GransloJorunn Pauline Cavanagh
Aug 30, 2019·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·K Renee TwibellHolly M Jones
May 26, 2018·Diagnosis·Giuseppe LippiAna-Maria Simundic
Oct 17, 2019·Clinical Chemistry and Laboratory Medicine : CCLM·Gro GidskeGunn B B Kristensen
Jul 1, 2018·The Journal of Applied Laboratory Medicine·James A MaysPatrick C Mathias
Jun 7, 2021·Joint Commission Journal on Quality and Patient Safety·Poonam GuptaMawahib El Hassan
Jul 25, 2021·Parasitology International·Orkhon BanzragchgaravYoshifumi Nishikawa
Jul 6, 2021·Clinical Chemistry and Laboratory Medicine : CCLM·Elena Revuelta-LópezAntoni Bayes-Genis
Oct 13, 2021·Annals of Laboratory Medicine·Fernando Marques-GarciaSandra Elena Pérez

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