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Due to the low use of the quality assessment of the hematological laboratories under the critical systematic error (ΔSE), and with the imperative to explore the implications of the use of the average of standard deviations and the control charts of each hematological parameter, we developed a prospective research at the University Clinic in Lima, Peru. We analyzed eight hematological parameters under the CLSI EP-15 A2 and CLSI H26-A2 guidelines for 19 days in the Landwind LW D3600 hematology autoanalyzer. In total, 1368 assays were performed (171 runs for each hematological parameter and 57 for each control level), which generated 19 averages in each level and for each parameter where we found 90 violations of the Westgard rules. Performance characteristics were optimal for leukocyte count (white blood cell) and platelets (ΔSE = ≥ 5.8) and were deficient for all erythrocyte parameters (ΔSE = 0.17-3.27). We identify significant differences between the determined automatic mean (by the autoanalyzer) and the calculated mean, having in many cases marked the difference. The quality evaluation of the ΔSE analysis showed a heterogeneous performance and intra-parameter control levels, as well as violations of the Westgard rules and mismatches in the determination of means (calculated and automatic).

RESUMENObjetivo: Evaluar la depleción del suministro de sangre y el costo por donaciones indeterminadas del Hospital Nacional Guillermo Almenara Irigoyen durante el 2014. Materiales y métodos: Estudio retrospectivo de corte transversal y análisis de costo-utilidad en donaciones con resultados en zona gris (valor de la muestra/ valor de corte entre los límites > 0.85 y < 1) luego del tamizaje serológico para los siete marcadores infecciosos (HIV, HBsAg, HBcAb, HCV, HTLV-1/2, SÍFILIS y CHAGAS) y la determinación en simultáneo del HIV Ag/Ab combo, por ELISA de cuarta generación. Desde el sistema e-Delphyn® se codificaron y tabularon los datos. El análisis de costos se realizó considerando el tipo de cambio vigente. Resultados: De 9 560 donaciones, el 20.7 % (1977 donaciones) fueron resultados en zona gris lo que ocasionó una pérdida de 863.9 litros de sangre y 92 640 USD. HbcAb con 10.18% (973 resultados indeterminados) y anti-HIV con 0.39% (37 resultados indeterminados) fueron los resultados con mayor y menor seroprevalencia, respectivamente (p<0.05). No se encontró diferencias significativas entre los marcadores anti-HIV y HIV Ag/Ab combo (p=0.776). Conclusiones: Se demostró que >800 litros de sangre descartada generó >90 mil USD de costo por donaciones indeterminadas ocasionando un perjuicio económico al presupuesto hospitalario y una disminución del suministro de sangre disponible para el tratamiento de pacientes en el Hospital Nacional Guillermo Almenara Irigoyen.Palabras clave: Zona gris; donación de sangre; marcadores infecciosos; tamizaje. Depletion of blood supply and cost due to indeterminate donations at the Guillermo Almenara Irigoyen National Hospital ABSTRACTObjective: To evaluate the depletion of blood supply and the cost due to indeterminate donations at Hospital Nacional Guillermo Almenara Irigoyen during 2014. Materials and methods: A retrospective cross-sectional study and a cost-utility analysis were conducted in donations showing results in the gray zone (sample value/cutoff value between >0.85 and <1) after a serological screening of seven infectious markers (HIV, HBsAg, HBcAb, HCV, HTLV-1/2, syphilis and Chagas disease) and the simultaneous determination of the HIV Ag/Ab combo by means of a fourth generation ELISA. Data was encoded and tabulated using the e-Delphyn® system. The cost-utility analysis was performed considering the current exchange rate. Results: Out of 9,560 donations, 20.7% (1977 donations) showed results in the gray zone which caused a loss of 863.9 liters of blood and USD 92,640. The highest and lowest rate of seroprevalence were observed in HBcAb with 10.18% (973 indeterminate test results) and anti-HIV with 0.39% (47 indeterminate test results), respectively (p<0.05). No significant differences were found between the anti-HIV y HIV Ag/Ab combo screening methods (p=0.776). Conclusions: It was demonstrated that more than 800 liters of discarded blood generated a more than USD 90,000 cost due to indeterminate donations causing economic damages to the hospital budget and a de...

Rendimiento diagnóstico del agar sangre con filtro versus agar karmali para el diagnóstico de Campylobacter en coprocultivo