A statistical model for restoration of serum potassium level disturbed by hemolysis
Wei-Zheng Zhang1, David J Price2
1Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital & The University of Melbourne, Victoria, Australia.
Background:
Blood sample hemolysis affects pre-analytical quality and may cause pseudohyperkalemia. We established a statistical model to estimate the corrected potassium (K+) in serum.
Methods:
Serum K+ and H index were analyzed, and blood cell index was obtained from the examined Full Blood Examination (FBE) results. A linear-regression model was developed using hemolysis (H) index, K+ and covariates of blood cell index from 139 cell lysates of blood samples. The model was then validated against 26 in vitro physically hemolyzed serum samples.
Results:
The final model selected H index, hemoglobin concentration (HGB), and hematocrit (HCT) as important predictors in estimating the K+ content. The model was validated against artificially hemolyzed serum samples, which returned a correlation of 0.942 between observed and predicted net K+ increase by hemolysis. The predictors H index, HCT, and HB contributed 93.7%, 3.5% and 2.8% to the model R2, respectively.
Conclusion:
In vitro hemolysis induced pseudohyperkalemia could be accurately predicted and restored by our model for clinical application.
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