Development of an Integrated Reporting System for Verifying Hemolysis, Icterus, and Lipemia in Clinical Chemistry Results

Abstract

BackgroundHemolysis, icterus, and lipemia (HIL) cause preanalytical interference and vary unpredictably with different analytical equipments and measurement methods. We developed an integrated reporting system for verifying HIL status in order to identify the extent of interference by HIL on clinical chemistry results.MethodsHIL interference data from 30 chemical analytes were provided by the manufacturers and were used to generate a table of clinically relevant interference values that indicated the extent of bias at specific index values (alert index values). The HIL results generated by the Vista 1500 system (Siemens Healthcare Diagnostics, USA), Advia 2400 system (Siemens Healthcare Diagnostics), and Modular DPE system (Roche Diagnostics, Switzerland) were analyzed and displayed on physicians' personal computers.ResultsAnalytes 11 and 29 among the 30 chemical analytes were affected by interference due to hemolysis, when measured using the Vista and Modular systems, respectively. The hemolysis alert indices for the Vista and Modular systems were 0.1-25.8% and 0.1-64.7%, respectively. The alert indices for icterus and lipemia were <1.4% and 0.7% in the Vista system and 0.7% and 1.0% in the Modular system, respectively.ConclusionsThe HIL alert index values for chemical analytes varied depending on the chemistry analyzer. This integrated HIL reporting system provides an effective screening tool for verifying specimen quality with regard to HIL and simplifies the laboratory workflow.

The impact of venepuncture training on the reduction of pre‐analytical blood sample haemolysis rates: A systematic review

“…While the automated identification of haemolysis (from the results of the analyser) may discourage subjectivity in detection of haemolysed samples, there seems to be a lack of standardisation in threshold setting between different analysers. These inconsistencies have also been reported by Lippi et al () and Shin et al (). Between‐analyser variability has been especially reported for the ADVIA 2400 and 1800 Dimensions (Lippi et al, ).…”

Deceased tissue donor serology and molecular testing for HIV, hepatitis B and hepatitis C viruses: a lack of cadaveric validated tests

“…The manufacturers indicated 5 g/L BioKit Ò (Bioelisa Ò HIV 1/2 3.0 2012) and DiaSorin Ò (LIAISON Ò HBc IgM 2014) and 36 g/L on BioRad Ò (MONOLISA Ò anti-HBc PLUS 2006) as the limit range for triglycerides. An integrated reporting system for verifying hemolysis, icterus, and lipemia was recently developed (Shin et al 2014) and is a helpful tool to elucidate the limit of lipemia in blood samples for virus serological screening assays.…”

Utility of icteric index in clinical laboratories: more than a preanalytical indicator

“…Depending on manufacturers, measurement of serum indices requires a specific reagent or only saline solution or water. HIL index is not directly reported on laboratory reports since it does not guide a clinical action and are commonly used to decide if the result of a certain laboratory parameter is rejected, reported or reported with an annotation (5,6). There is a striking debate regarding the most appropriate and reliable strategy for dealing with pre-analytically altered laboratory test results, especially of those obtained in haemolysed samples (7)(8)(9)(10).…”