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Indirect reference intervals for haematological parameters in capillary blood of pre-school children
Aleksandra Zeljkovic1, Zsófia Csuzdi Balog2, Eva Dukai3
1Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
Insights
This study assessed reference intervals (RIs) for haematological parameters in pre-school children using an indirect method. The derived RIs differed from literature-based values, highlighting the need for intra-laboratory RIs.
Area of Science:
- Clinical Chemistry
- Paediatric Haematology
- Laboratory Medicine
Background:
- Reference intervals (RIs) are crucial for interpreting laboratory test results.
- Indirect estimation offers a cost-effective method for determining intra-laboratory RIs.
- Assessing RIs in specific populations, like pre-school children, is essential for accurate diagnostics.
Purpose of the Study:
- To determine intra-laboratory reference intervals (RIs) for haematological parameters in pre-school children.
- To evaluate the applicability of the indirect method for RI assessment in this age group.
- To compare the derived RIs with existing literature-based RIs.
Main Methods:
- Utilized retrospective data from a laboratory information system for 154 boys and 146 girls.
- Employed an automatic haematology analyzer for capillary blood samples.
- Calculated RIs using the nonparametric percentile method after data distribution testing and logarithmic transformation when necessary.
Main Results:
- Calculated reference intervals for numerous haematological parameters including RBC count, haemoglobin, WBC count, and platelet count.
- Established gender-specific RIs for monocytes, haematocrit, MCV, and RDW due to statistically significant differences.
- Observed marked variations between the estimated RIs and literature-based RIs.
Conclusions:
- The indirect method provides a straightforward approach for assessing RIs in pre-school children.
- The study underscores the necessity of intra-laboratory RI determination for specific populations and sample types.
- Derived RIs differed significantly from literature values, emphasizing the importance of localized RI establishment.
Introduction:
Indirect estimation of reference intervals (RIs) is straightforward and inexpensive procedure for determination of intra-laboratory RIs. We applied the indirect approach to assess RIs for haematological parameters in capillary blood of pre-school children, using results stored in our laboratory database.
Materials And Methods:
We extracted data from laboratory information system, for the results obtained by automatic haematology analyser in capillary blood of 154 boys and 146 girls during pre-school medical examination. Data distribution was tested, and logarithmic transformation was applied if needed. Reference intervals were calculated by the nonparametric percentile method.
Results:
Reference intervals were calculated for: RBC count (4.2-5.4 x1012/L), haemoglobin (114-146 g/L), MCH (25.0-29.4 pg), MCHC (321-368 g/L), RDW-SD (36.1-43.5 fL), WBC count (4.5-12.3 x109/L), neutrophils count (1.7-6.9 x109/L) and percentage (29.0-69.0%), lymphocytes count (1.6-4.4 x109/L) and percentage (21.9-60.7%), PLT (165-459 x109/L), MPV (8.1-11.4 fL) and PDW (9.2-14.4%). Gender specific RIs were calculated for monocytes count (male (M): 0.2-1.6 x109/L; female (F): 0.1-1.4 x109/L) and percentage (M: 2.5-18.3%; F: 1.8-16.7%), haematocrit (M: 0.34-0.42 L/L; F: 0.34-0.43 L/L), MCV (M: 73.4-84.6 fL; F: 75.5-84.2 fL) and RDW (M: 12.1-14.3%; F: 11.7-13.9%), due to observed gender differences in these parameters (P = 0.031, 0.028, 0.020, 0.012 and 0.001; respectively). Estimated RIs markedly varied from the literature based RIs that are used in the laboratory.
Conclusions:
Indirect method employed in this study enables straightforward assessment of RIs in pre-school children. Herein derived RIs differed from the literature-based ones, indicating the need for intra-laboratory determination of RIs for specific populations and sample types.
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