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Characterization of analytical errors in thromboelastography interpretation.

Tapasyapreeti Mukhopadhyay1, Arulselvi Subramanian2, Hara Prasad Pati3,4

  • 1Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute Medical Sciences, New Delhi, 110029, India.

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|January 1, 2021
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Summary

Analytical errors in Thromboelastography (TEG) interpretation were found in 16.2% of cases, with nearly half being preventable. Improving awareness of common TEG errors is crucial for patient safety and timely treatment.

Keywords:
Diagnostic delayLaboratory errorPatient safetyTEG misinterpretationTurnaround time

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Area of Science:

  • Laboratory Medicine
  • Hematology
  • Clinical Pathology

Background:

  • Thromboelastography (TEG) interpretation requires expertise, correlating clinical data with TEG parameters and tracings while considering potential errors.
  • A lack of literature on analytical errors in TEG interpretation prompted this study.

Purpose of the Study:

  • To analyze the types and frequency of analytical errors in Thromboelastography (TEG) interpretation.
  • To identify the proportion of preventable analytical errors in TEG analysis.

Main Methods:

  • A retrospective review of 440 TEG tracings from an apex trauma center in North India.
  • Exclusion of cases with pre-analytical errors, missing data, or runs <10 minutes.
  • Classification of analytical errors into preventable, potentially preventable, and non-preventable categories.

Main Results:

  • An analytical error was identified in 16.2% (60/370) of reviewed TEG tracings.
  • The most common analytical error was tracings of severe hypocoagulable states (k-time = 0) (33.3%), followed by irregular spikes (30%).
  • Of the analytical errors, 48.2% were preventable and 8.3% were potentially preventable.

Conclusions:

  • Analytical errors impact approximately one-sixth of TEG interpretations, with a significant portion being preventable.
  • Increased awareness of common analytical errors among clinicians and laboratory physicians is vital.
  • Addressing these errors can prevent treatment delays and enhance patient safety.