Alsina Ma Jesús, Alvarez Virtudes, Barba Núria, Bullich Sandra, Cortés Mariano, Escoda Irene, Martínez-Brú Cecília
SEQC Committee for the Quality of the Extraanalytical Phase, Spain.
Clin Chem Lab Med. 2008;46(6):849-54. doi: 10.1515/CCLM.2008.168.
Preanalytical variables, such as sample collection, handling, transport, and storage, may affect patient results. The number of errors in the preanalytical phase may decrease by following standardized procedures.
A retrospective analysis (2001-2005) of results obtained through the Spanish Society of Clinical Chemistry and Molecular Pathology Quality Assessment Program for the Preanalytical Phase has been carried out to summarize data regarding the main factors affecting the preanalytical phase quality. In such a program, participants are asked to register rejections and causes for rejection of routine or stat samples usually and locally collected at their laboratories.
Results discussed refer to 105 laboratories. Of the 4,715,132 tubes expected to be received during the data collection period among participating laboratories and according to determinations included by clinicians in the request form, 32,977 (0.699%) offered a cause for rejection. Whole blood-EDTA samples and serum samples accounted for 75.6% of all samples collected among laboratories, although they only corresponded to 55.8% of all registered rejections. In total, 81% of rejections arose as a result of the following reasons: "specimen not received" (37.5%), "hemolysis" (29.3%), and "clotted sample" (14.4%). Moreover, plasma-citrate-erythrocyte sedimentation rate exhibited the highest percentage of rejection (1.473%), whereas the lowest rate corresponded to whole blood-EDTA (0.381%).
Overall percentage of rejection is similar to previously published data. As some of the included variables have turned out to be irrelevant, the program has been simplified from the year 2006 onwards.
分析前变量,如样本采集、处理、运输和储存,可能会影响患者检测结果。遵循标准化程序可减少分析前阶段的误差数量。
对通过西班牙临床化学与分子病理学学会分析前阶段质量评估项目获得的结果进行回顾性分析(2001 - 2005年),以总结有关影响分析前阶段质量的主要因素的数据。在该项目中,要求参与者记录通常在其实验室本地采集的常规或急诊样本的拒收情况及拒收原因。
讨论的结果涉及105家实验室。在数据收集期间,参与实验室预计收到的4,715,132支试管中,根据临床医生在申请表中包含的测定,有32,977支(0.699%)存在拒收原因。全血乙二胺四乙酸(EDTA)样本和血清样本占实验室采集的所有样本的75.6%,尽管它们仅占所有记录拒收样本的55.8%。总体而言,81%的拒收是由以下原因导致的:“样本未收到”(37.5%)、“溶血”(29.3%)和“样本凝血”(14.4%)。此外,血浆柠檬酸盐红细胞沉降率样本的拒收率最高(1.473%),而最低拒收率对应全血EDTA样本(0.381%)。
总体拒收率与先前公布的数据相似。由于部分纳入变量已被证明无关紧要,该项目自2006年起已简化。