McMaster University, Hamilton, Canada.
Am J Clin Pathol. 2011 Dec;136(6):836-41. doi: 10.1309/AJCP8O8GIPPPNUSH.
Critical values are vital to safe clinical and laboratory practice. To address the lack of information on critical values in coagulation, pattern-of-practice surveys were distributed to members of the North American Specialized Coagulation Laboratory Association. More than 70% of respondents had critical values for commonly performed tests. Median values were as follows: prothrombin time, more than 37 seconds; international normalized ratio, more than 5; activated partial thromboplastin time, more than 100 seconds; and fibrinogen level, less than 100 mg/dL. Critical value reporting generated a significant workload, with up to 15% of these tests yielding critical results. The median time to report critical values was 7 minutes for inpatients. Despite the lack of guidelines surrounding critical values in coagulation, this survey confirms that laboratories have reasonable and uniform practices. It also provides critical value medians and ranges for a wide range of tests. Laboratories without critical values or in the process of reviewing their values may find this survey of their peers useful.
危急值对安全的临床和实验室实践至关重要。为了解决凝血危急值信息不足的问题，向北美专业凝血实验室协会的成员分发了实践模式调查。超过 70%的受访者对常见检测项目有危急值。中位数如下：凝血酶原时间，超过 37 秒；国际标准化比值，超过 5；活化部分凝血活酶时间，超过 100 秒；纤维蛋白原水平，低于 100mg/dL。危急值报告产生了大量的工作量，多达 15%的这些检测结果产生了危急值。住院患者报告危急值的中位数时间为 7 分钟。尽管在凝血危急值方面缺乏指南，但这项调查证实了实验室具有合理且统一的实践。它还为广泛的检测项目提供了危急值中位数和范围。没有危急值或正在审查其值的实验室可能会发现这项同行调查很有用。
