A multicenter reference interval study of thromboelastography in the Chinese adult population.


Journal

Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377

Informations de publication

Date de publication:
11 2020
Historique:
received: 14 04 2020
revised: 07 06 2020
accepted: 07 07 2020
pubmed: 28 7 2020
medline: 22 6 2021
entrez: 26 7 2020
Statut: ppublish

Résumé

Imprecise reference intervals (RIs) adversely impact the determination of the need for blood transfusion and clinical diagnosis and treatment of coagulopathy. However, there are few RI studies of thromboelastography (TEG) based on a standard protocol. The present multicenter study aimed to establish RIs for the adult Chinese population. Healthy participants were recruited from 6 medical centers by non-probability sampling. Blood samples were subjected to laboratory TEG analysis. The Ichihara method, 2-level nested analysis of variance (ANOVA) (2N-ANOVA), and the latent abnormal values exclusion (LAVE) were used to define the RIs following recommendations of the Clinical and Laboratory Standards Institute and International Federation of Clinical Chemistry and Laboratory Medicine, Committee on Reference Intervals and Decision Limits. Multiple regression analysis was performed to explore sources of variation. A total of 507 healthy participants were enrolled into the study cohort. Twenty-five individuals with potential coagulopathy were secondarily excluded by LAVE. Smoking was related to reaction time, α angle, and coagulation index in the TEG test (P < 0.05). 2N-ANOVA revealed that the RIs of all 5 test items of TEG needed to be partitioned by age and sex. Finally, TEG RIs were derived both parametrically and nonparametrically for males or females and different age Groups, respectively. TEG RIs were established for the adult Chinese population using up-to-date methodology. The results will provide a useful and essential comparator for patients in the assessment of coagulation state, goal-directed blood transfusion therapy, and monitoring of the pharmacodynamic effects of anticoagulant drugs.

Sections du résumé

BACKGROUND
Imprecise reference intervals (RIs) adversely impact the determination of the need for blood transfusion and clinical diagnosis and treatment of coagulopathy. However, there are few RI studies of thromboelastography (TEG) based on a standard protocol. The present multicenter study aimed to establish RIs for the adult Chinese population.
METHODS
Healthy participants were recruited from 6 medical centers by non-probability sampling. Blood samples were subjected to laboratory TEG analysis. The Ichihara method, 2-level nested analysis of variance (ANOVA) (2N-ANOVA), and the latent abnormal values exclusion (LAVE) were used to define the RIs following recommendations of the Clinical and Laboratory Standards Institute and International Federation of Clinical Chemistry and Laboratory Medicine, Committee on Reference Intervals and Decision Limits. Multiple regression analysis was performed to explore sources of variation.
RESULTS
A total of 507 healthy participants were enrolled into the study cohort. Twenty-five individuals with potential coagulopathy were secondarily excluded by LAVE. Smoking was related to reaction time, α angle, and coagulation index in the TEG test (P < 0.05). 2N-ANOVA revealed that the RIs of all 5 test items of TEG needed to be partitioned by age and sex. Finally, TEG RIs were derived both parametrically and nonparametrically for males or females and different age Groups, respectively.
CONCLUSIONS
TEG RIs were established for the adult Chinese population using up-to-date methodology. The results will provide a useful and essential comparator for patients in the assessment of coagulation state, goal-directed blood transfusion therapy, and monitoring of the pharmacodynamic effects of anticoagulant drugs.

Identifiants

pubmed: 32711234
pii: S0049-3848(20)30310-8
doi: 10.1016/j.thromres.2020.07.019
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

180-186

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Xianfei Zeng (X)

Department of Laboratory Medicine, Shaanxi Corps Hospital, Chinese People's Armed Police Forces, Xi'an 710054, China; School of Medicine, Northwest University, Xi'an 710069, China; The National Engineering Research Center for Miniaturized Detection Systems, College of Life Science, Northwest University, Xi'an 710069, China.

Le Fang (L)

Department of Laboratory Medicine, 521 Hospital of Ordnance Industry, Xi'an 710065, China.

Yongping Peng (Y)

Department of Transfusion Medicine, Xi'an Aerospace General Hospital, Xi'an 710100, China.

Yangmin Zhang (Y)

Department of Transfusion Medicine, Xi'an Central Hospital, Xi'an 710003, China.

Xiaoyan Li (X)

Department of Transfusion Medicine, Baoji Central Hospital, Baoji 721008, China.

Zhaolong Wang (Z)

Department of Transfusion Medicine, Xi'an Central Hospital, Xi'an 710003, China.

Baoping Zhang (B)

Department of Transfusion Medicine, Xijing Hospital, Xi'an 710032, Fourth Military Medical University, China.

Qian Cao (Q)

Department of Laboratory Medicine, Shaanxi Corps Hospital, Chinese People's Armed Police Forces, Xi'an 710054, China.

Xingbin Hu (X)

Department of Transfusion Medicine, Xijing Hospital, Xi'an 710032, Fourth Military Medical University, China. Electronic address: hxbyqh@fmmu.edu.cn.

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