Abstract
Blood coagulation tests are essential for accurate diagnosis and treatment, including assessment of preoperative hemostasis, identification of bleeding or thrombophilia, and monitoring the efficacy of anticoagulant therapy. In our laboratory, blood sample re-collection for coagulation tests is requested if any of the following three criteria are met: (1) Coagulation is suspected in a concurrently collected CBC. (2) Abnormal test values are detected (deviation from the previous APTT, PT values, etc., shortening of APTT, or measurement errors). (3) Clot formation is observed in the erythrocyte layer post-measurement. In this study, we evaluated to verify whether the suspected coagulation specimens increased coagulation or fibrinolysis in each of the three criteria. We analyzed 101 pairs of suspected coagulation and re-collected specimens and performed the following tests on another day: APTT, PT, fibrinogen, FDP, D-dimer, FM, TAT, PIC, and tPAI·C. The proportions of the initial criteria were as follows: (1) suspected CBC coagulation in 57 cases (56%), (2) abnormal test values in 34 cases (34%), and (3) confirmation of coagulum post-measurement in 10 cases (10%). Criteria (1) and (2) showed significant differences for all items, whereas criterion (3) showed significant differences except for APTT, D-dimer, and PIC. Our results support the effectiveness of a multi-step procedure for excluding unsuitable samples. The test values of coagulation-suspected specimens confirmed by the operational procedure showed significant fluctuations compared to re-collected specimens. Therefore, re-collecting revealed elevated levels of coagulation or fibrinolysis in the coagulation-suspect specimen.
