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Screening INR deviation of local prothrombin time systems

L Poller1

  • 1Department of Pathological Sciences, University of Manchester, UK.

Journal of Clinical Pathology
|August 26, 1998
PubMed
Summary
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Freeze-dried plasma screening sets effectively identified inaccurate international normalized ratio (INR) results in many coagulometer users. Local calibration and supplementary exercises improved accuracy for both automated and manual testing methods.

Area of Science:

  • Clinical Pathology
  • Laboratory Medicine

Background:

  • Accurate monitoring of anticoagulation therapy is crucial for patient safety.
  • International Normalized Ratio (INR) is a standardized measure of prothrombin time.
  • Variability in INR testing can arise from local laboratory practices and reagents.

Purpose of the Study:

  • To evaluate the reliability of local INR measurements.
  • To assess the effectiveness of international reference preparation (IRP) certified freeze-dried plasmas for quality control.

Main Methods:

  • 55 centers in the UK and Ireland participated, using either coagulometers or manual prothrombin time techniques.
  • Participants used a standardized batch of commercial thromboplastin and IRP-certified freeze-dried plasmas for testing.
  • An INR deviation exceeding +/- 10% from the certified value was considered unsatisfactory.

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Main Results:

  • 15 of 38 coagulometers and 3 of 19 manual techniques yielded unsatisfactory INR results.
  • Local ISI calibrations resolved issues in 10 of 15 unsatisfactory coagulometer results.
  • Manual technique errors were corrected by using provided freeze-dried normal plasmas.

Conclusions:

  • Freeze-dried plasma screening sets are valuable tools for detecting incorrect INR values.
  • The screening method proved effective for a majority of coagulometer users and a subset of manual technique users.