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Published on: March 20, 2021
Rapid Centrifugation for Coagulation Testing: A Multianalyzer Validation Study Harmonizing Preanalytical Protocols
Orakan Limpornpugdee1, Jirapa Kaewkhruawan2, Pitchayaporn Riyagoon2
1Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Objectives:
Centrifugation requirements differ between coagulation and clinical chemistry testing, potentially limiting workflow efficiency and total laboratory automation (TLA). Coagulation assays typically require standard centrifugation at 1500 g for 15 min, whereas chemistry samples use a rapid protocol at 2300 g for 5 min. This study evaluated the impact of rapid centrifugation on prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer results.
Methods:
Blood samples were prospectively collected from volunteers in 3, 2, and pediatric 1 mL citrate tubes and were processed using standard or rapid centrifugation. Testing was performed for PT, APTT, and D-Dimer on Sysmex CN3000 and ACL-TOP 750 analyzers, with residual platelet counts assessed.
Results:
A total of 130 samples were analyzed (41 from 3 mL tubes, 41 from 2 mL tubes, and 39 from 1 mL tubes). Rapid centrifugation produced significantly higher residual platelet counts than the standard protocol (39.2 × 109/L vs. 18.8 × 109/L, p < 0.0001). Strong correlations (r > 0.9) were observed for PT and APTT across analyzers, while D-dimer results on ACL-TOP 750 showed slightly lower correlation (r = 0.830). Bland-Altman analysis demonstrated small mean biases (< 1% for PT and APTT). D-dimer biases from CN3000 and ACL-TOP 750 were 1.06% and -2.70%, respectively, which remained within the predefined total allowable error. Residual platelets showed no impact on test results.
Conclusions:
Rapid centrifugation at 2300 g for 5 min provides coagulation results comparable to the standard protocol and may facilitate integration of coagulation testing into TLA workflows.
