Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria.
Clin Chim Acta. 2018 Jul;482:124-135. doi: 10.1016/j.cca.2018.04.003. Epub 2018 Apr 4.
Practical and ethical challenges as well as time and costs have restricted the generation of pediatric reference intervals. Therefore, pediatric reference intervals on coagulation parameters based on solid evidence are still scarce. Furthermore, reference intervals by age-group cannot reflect the dynamics of age and sex specific coagulation values during childhood. This study is the first to close this gap and provide continuous age and sex dependent reference intervals during childhood in hemostasis.
We used an innovative indirect method for providing continuous reference intervals for five common coagulation parameters: Activated partial thromboplastin time (aPTT), prothrombin time (PT), thrombin clotting time (TT), fibrinogen (FIB) and antithrombin (AT). Calculations were performed using retrospective laboratory data from pediatric patients between 2005 and 2015 of two major Austrian hospitals, resulting in a total of 195.360 measurements (aPTT: 55,100; PT: 35,492; TT: 35,295; FIB: 49,789; AT: 19,684).
This multicenter study provides calculations of continuous reference intervals for five common coagulation parameters in a large pediatric cohort, accounting for age and gender.
To the best of our knowledge, this is the first multicenter study, determining continuous pediatric coagulation reference intervals based on a large retrospective dataset.
实际和伦理方面的挑战以及时间和成本的限制,使得小儿参考区间的建立受到了限制。因此,基于确凿证据的小儿凝血参数参考区间仍然很少。此外,按年龄组划分的参考区间并不能反映儿童期特定年龄和性别凝血值的动态变化。本研究首次填补了这一空白,提供了小儿止血过程中连续的年龄和性别相关参考区间。
我们使用了一种创新的间接方法,为五个常见凝血参数提供连续参考区间:活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)和抗凝血酶(AT)。计算是使用来自 2005 年至 2015 年奥地利两家主要医院的儿科患者的回顾性实验室数据进行的,共获得了 195360 次测量值(aPTT:55100;PT:35492;TT:35295;FIB:49789;AT:19684)。
这项多中心研究提供了在大型儿科队列中,考虑到年龄和性别因素的五个常见凝血参数的连续参考区间计算值。
据我们所知,这是第一项基于大型回顾性数据集确定小儿连续凝血参考区间的多中心研究。