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Direct international normalized ratio determination using multicalibrators is more responsive than the conventional

C-H Cha¹, C-J Park, D H Kim

¹Department of Laboratory Medicine, University of Ulsan College of Medicine and Gangneung Asan Hospital, Gangneung, Korea.

International Journal of Laboratory Hematology

|November 3, 2009

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Directly determining the International Normalized Ratio (INR) using a multicalibrator enhances accuracy. This method showed higher INR values compared to conventional calculations, indicating greater responsiveness in anticoagulation monitoring.

Area of Science:

Clinical Chemistry
Hematology
Medical Diagnostics

Background:

Accurate International Normalized Ratio (INR) monitoring is crucial for patients on anticoagulation therapy.
Conventional INR determination relies on mean normal prothrombin time and instrument/reagent-specific International Sensitivity Index (ISI).
Improving the precision and accuracy of INR determination is an ongoing clinical need.

Purpose of the Study:

To evaluate the utility of a multicalibrator for direct International Normalized Ratio (INR) determination.
To compare direct INR measurement with the conventional method in a clinical setting.

Main Methods:

A total of 493 blood samples (320 anticoagulated patients, 173 controls) were analyzed.
INR values were measured using a CA-7000 coagulation analyzer with Thromborel S reagent.

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Direct INR values were obtained using a PT-Multi Calibrator, while conventional INR was calculated using standard parameters.

Main Results:

The mean INR value obtained by the direct method was significantly higher than that of the conventional method.
The difference between direct and conventional INR values increased proportionally with higher INR levels.
The direct INR method demonstrated greater responsiveness in detecting INR elevations.

Conclusions:

Direct INR determination using a multicalibrator offers improved responsiveness and accuracy compared to conventional methods.
This approach provides a more sensitive assessment of anticoagulation status.
The direct method is recommended for more precise INR monitoring in clinical practice.