Inaccuracy of the 'derived' fibrinogen measurement

The 'derived' fibrinogen method is commonly used for the measurement of plasma fibrinogen. This method is not a direct quantitation of plasma fibrinogen, but an estimation of the fibrinogen concentration from the clotting curve of the prothrombin time on automated photo-optical coagulometers. An increasing number of laboratories are now routinely using this method to cope with increasing demands for fibrinogen testing. To study the suitability of this method for routine laboratory use a total of 58 samples, 20 healthy normals and 38 from other patient groups were tested by the 'derived' and Clauss fibrinogen methods on the ACL 300R. The results clearly demonstrated that 'derived' fibrinogen assay values were significantly higher than the Clauss measurements. The discrepancy between 'derived' and Clauss fibrinogen levels was greater in certain patient groups, e.g. patients receiving oral anticoagulants, than in normal controls. Some patients with documented hypodysfibrinogenaemia with low fibrinogen levels by Clauss assay gave normal 'derived' fibrinogen values. Although the 'derived' fibrinogen assay is rapid, economical and easily available to laboratories with suitable instruments, this study shows that it lacks standardization and is inaccurate compared with the Clauss assay.