Dynamic reference intervals for coagulation parameters from infancy to adolescence

Area of Science:

• Pediatric Hematology
• Clinical Biochemistry
• Laboratory Medicine

Background:

• Pediatric reference intervals for coagulation parameters are scarce due to practical, ethical, and cost challenges.
• Existing age-group intervals fail to capture dynamic age and sex-specific coagulation values in children.
• There is a significant need for reliable, continuous reference intervals in pediatric hemostasis.

Purpose of the Study:

• To establish continuous, age- and sex-dependent reference intervals for key coagulation parameters in children.
• To address the gap in evidence-based pediatric reference ranges for hemostasis.
• To provide a valuable resource for accurate diagnosis and monitoring of coagulation disorders in pediatric patients.

Main Methods:

• Utilized an innovative indirect method to generate continuous reference intervals.
• Analyzed retrospective laboratory data from pediatric patients (2005-2015) across two Austrian hospitals.
• Included a large dataset of 195,360 measurements for five common coagulation parameters: aPTT, PT, TT, fibrinogen (FIB), and antithrombin (AT).

Main Results:

• Successfully calculated continuous reference intervals for five common coagulation parameters.
• The intervals are dependent on both age and gender, reflecting pediatric physiology.
• This multicenter study provides data for a large pediatric cohort.

Conclusions:

• This is the first multicenter study to determine continuous pediatric coagulation reference intervals using a large retrospective dataset.
• The findings offer a significant advancement in establishing evidence-based hemostasis reference ranges for children.
• The generated intervals will aid in more precise clinical interpretation of coagulation tests in pediatric populations.