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Paediatric reference intervals for common coagulation assays in Chinese children as performed on the STA-R

Junjie Liu1, Yanpeng Dai2, Enwu Yuan2

  • 1Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

International Journal of Laboratory Hematology
|August 20, 2019
PubMed

Insights

Establishing age-specific reference intervals for coagulation tests is crucial for managing paediatric patients with bleeding disorders. This study determined these intervals for prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (aPTT), and fibrinogen (Fg) in children.

Area of Science:

  • Paediatric Haematology
  • Clinical Coagulation Science
  • Biostatistics

Background:

  • Accurate management of paediatric patients with haemostatic disorders requires age-appropriate reference intervals.
  • Current reference intervals are often based on adult data, potentially leading to misinterpretation in children.
  • Establishing specific intervals for paediatric populations is essential for reliable diagnostic evaluation.

Purpose of the Study:

  • To determine age-specific reference intervals for key coagulation parameters in children.
  • To provide accurate benchmarks for prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (aPTT), and fibrinogen (Fg) in paediatric patients.
  • To support improved clinical decision-making for children with suspected or confirmed bleeding disorders.

Main Methods:

  • Analysis of coagulation assays (PT, TT, aPTT, Fg) from 34,234 apparently healthy children aged 0-15 years.
  • Utilized the STA-R coagulation analyzer for all measurements.
  • Employed Dixon's D/R ratio rule for outlier elimination and Harris and Boyd's standard normal deviate test for age partitioning.
  • Established lower (2.5th) and upper (97.5th) percentiles using a nonparametric method.

Main Results:

  • Significant differences in median PT values were observed across various paediatric age groups compared to adults.
  • Activated partial thromboplastin time (aPTT) and thrombin time (TT) were significantly prolonged in all paediatric age groups relative to adults.
  • Median fibrinogen (Fg) values showed significant differences between specific paediatric age groups and adults.
  • All coagulation assays demonstrated a clear dependence on age, necessitating age-specific partitioning.

Conclusions:

  • Coagulation assay results are highly age-dependent in paediatric populations.
  • Age-specific reference intervals are imperative for the accurate evaluation of paediatric coagulation.
  • Implementing these age-specific intervals will enhance the diagnosis and management of haemostatic disorders in children.
Abstract

Keywords:
age groupsbloodhaemostasispaediatricsreference values

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