Jensen Esther A, Stahl Marta, Brandslund Ivan, Grinsted Per
Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark.
Clin Chem Lab Med. 2008;46(2):225-34. doi: 10.1515/CCLM.2008.053.
In many countries and especially in Scandinavia, blood samples drawn in primary healthcare are sent to a hospital laboratory for analysis. The samples are exposed to various conditions regarding storage time, storage temperature and transport form. As these factors can have a severe impact on the quality of results, we wanted to study which combination of transport conditions could fulfil our pre-defined goals for maximum allowable error.
Samples from 406 patients from nine general practitioners (GPs) in two Danish counties were sent to two hospitals for analyses, during two periods (winter and summer). Transport conditions (mail, courier pick-up, or brought to hospital by public coach), storage time, storage temperature and centrifugation requirements were different in the two counties. Results were tested for deviation from a "0-sample", the blood sample taken, centrifuged and separated at the doctor's office within 45-60 min. This sample was considered as the best estimate of a comparison value.
The pre-set quality goals were fulfilled for all the investigated components for samples transported to hospital by courier either as whole blood or as "on gel" after centrifugation, as long as the samples were stored at 20-25 degrees C and centrifuged/analysed within 5-6 h. A total of 4% of the samples sent by mail had mismatched identity, probably due to plasma being transferred to a new tube.
Samples can be sent as unprocessed anticoagulated whole blood if the above mentioned conditions are met. There is no need for centrifugation in the primary sector. Neither mailing of samples with plasma "on gel" nor public transport by coach bus fulfil our analytical goals.
在许多国家，尤其是斯堪的纳维亚地区，基层医疗保健机构采集的血样会被送往医院实验室进行分析。这些样本在储存时间、储存温度和运输方式等方面会受到各种条件的影响。由于这些因素可能对检测结果的质量产生严重影响，我们希望研究哪种运输条件组合能够满足我们预先设定的最大允许误差目标。
在两个时间段（冬季和夏季），将来自丹麦两个郡九名全科医生（GP）的406名患者的样本送往两家医院进行分析。两个郡的运输条件（邮寄、快递取件或由公共长途客车送往医院）、储存时间、储存温度和离心要求各不相同。检测结果与“0样本”的偏差，“0样本”是在医生办公室45至60分钟内采集、离心并分离的血样。该样本被视为比较值的最佳估计。
对于通过快递送往医院的样本，无论是全血还是离心后“置于凝胶上”的样本，只要样本储存在20至25摄氏度，并在5至6小时内进行离心/分析，所有研究成分的预设质量目标均能实现。通过邮寄的样本中，共有4%的样本身份不匹配，可能是由于血浆被转移到了新试管中。
如果满足上述条件，样本可以作为未处理的抗凝全血发送。基层医疗部门无需进行离心。邮寄带有“置于凝胶上”血浆的样本以及乘坐公共长途客车运输均无法实现我们的分析目标。
