Effect of Time and Temperature Variables on Prothrombin Time and International Normalized Ratio of Plasma in Patients in Gampaha, Sri Lanka
DOI:
https://doi.org/10.31964/mltj.v8i1.428Keywords:
International normalized ratio; prothrombin time; storage timeAbstract
Generating accurate results for Prothrombin time (PT) and International Normalized Ratio (INR), PT/INR test is paramount in treatment monitoring. The diagnosis process measures how long it takes blood to clot. The main objective of this study was to determine the effect of storage time and temperature variables on PT and INR results in patients attending Hematologic clinics in Sri Lanka. This cross-sectional study was conducted during June and July 2021. PT was measured in the plasma samples, stored at different temperatures at baseline (0 hours), and then after 12 hours, 18 hours, and 24 hours after specimen collection. INR was calculated from each result, and the deviation percentage of PT and INR was calculated compared to the baseline result (0 hours). Then PT and INR percentage deviation is grouped as <10% and >10% to find biologically significant variations while paired t-test was performed to find statistical significance using GraphPad prism 8.4.3. At refrigerated temperature, both PT and INR results showed>10% variation once kept 24 hours, and this variation was statistically significant (p<0.01, Wilcoxon matched paired sign ranked test). The plasma specimens kept at laboratory temperature and specimen collection room temperature for 18 hours indicated >10% variation of PT and INR values, while these variations were significant at the same criteria above. These results suggest that the separated plasma could only be recommended to test up to 12 hours. Therefore, the laboratories that operate in the same climatic conditions can now use these results to plan the specimen collection accordingly.References
Annual Health Bulletin. (2018). Ministry of Health. Sri Lanka.
Annual weather report. (2019). Ministry of Agriculture, Sri Lanka.
Awad, M. A., Selim, T. E., & Al-Sabbagh, F. A. (2004). Influence of storage time and temperature on international normalized ratio (INR) levels and plasma activities of vitamin K dependent clotting factors. Hematology, 9(5-6), 333-337.
Boissier, E., Sévin-Allouet, M., Le Thuaut, A., De Gaalon, S., Trossaërt, M., Rozec, B., & Rigal, J. C. (2017). A 2-min at 4500 g rather than a 15-min at 2200 g centrifugation does not impact the reliability of 10 critical coagulation assays. Clinical Chemistry and Laboratory Medicine (CCLM), 55(6), e118-e121.
Ciavarella, D., Reed, R. L., Counts, R. B., Baron, L., Pavlin, E., Heimbach, D. M., & Carrico, C. J. (1987). Clotting factor levels and the risk of diffuse microvascular bleeding in the massively transfused patient. British journal of haematology, 67(3), 365-368.
Dorgalaleh, A., Favaloro, E. J., Bahraini, M., & Rad, F. (2021). Standardization of prothrombin time/international normalized ratio (PT/INR). International Journal of Laboratory Hematology, 43(1), 21-28.
Dufour, D. R., Lott, J. A., Nolte, F. S., Gretch, D. R., Koff, R. S., & Seeff, L. B. (2000). Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clinical chemistry, 46(12), 2027-2049.
Huang, M. D., Weng, H. H., Hsu, S. L., Hsu, L. S., Lin, W. M., Chen, C. W., & Tsai, Y. H. (2019). Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: a single-center experience. Cancer Imaging, 19(1), 1-10.
Katulanda, P., Liyanage, I. K., Caldera, R., Constantine, G. R., Sheriff, R., & Mathews, D. (2010). Prevalence of ischaemic heart disease and its risk factors in Sri Lanka.
Loeliger, E. A., Van den Besselaar, A. M. H. P., & Lewis, S. M. (1985). Reliability and clinical impact of the normalization of the prothrombin times in oral anticoagulant control. Thrombosis and haemostasis, 53(01), 148-154.
Ozougwu, J. C. (2017). Physiology of the liver. International Journal of Research in Pharmacy and Biosciences, 4(8), 13-24.
Rao, L. V., Okorodudu, A. O., Petersen, J. R., & Elghetany, M. T. (2000). Stability of prothrombin time and activated partial thromboplastin time tests under different storage conditions. Clinica chimica acta, 300(1-2), 13-21.
Shikdar, S., & Bhattacharya, P.T. (2018). International normalized ratio (INR). In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2020.
Sivrikaya, A., Baran, H., Abusoglu, S., Ozturk, B., Vatansev, H., & Ali, U. N. L. U. (2013). Effect of gender and age on the prothrombin time (PT), activated partial thromboplastin time (aPTT) levels and international normalized ratio (INR). Int. J. Mevlana Med. Sci, 1(2), 27-30.
Smith, S. A., P. C. Comp, and J. H. Morrissey. (2006). Phospholipid composition controls thromboplastin sensitivity to individual clotting factors. Journal of Thrombosis and Haemostasis, 4(4), 820-827.
Sultan, A. (2010). Five-minute preparation of platelet-poor plasma for routine coagulation testing. EMHJ-Eastern Mediterranean Health Journal, 16(2), 233-236, 2010.
Toulon, P., Metge, S., Hangard, M., Zwahlen, S., Piaulenne, S., & Besson, V. (2017). Impact of different storage times at room temperature of unspun citrated blood samples on routine coagulation tests results. Results of a bicenter study and review of the literature. International journal of laboratory hematology, 39(5), 458-468.
Valiuddin, H., Alam, A., Calice, M., Boehm, K., Millard, J., Laforest, D., & Keyes, D. (2020). Utility of INR for prediction of delayed intracranial hemorrhage among warfarin users with head injury. The Journal of Emergency Medicine, 58(2), 183-190.
van Geest-Daalderop, J. H., Mulder, A. B., Boonman-de Winter, L. J., Hoekstra, M. M., & van den Besselaar, A. M. (2005). Preanalytical variables and off-site blood collection: influences on the results of the prothrombin time/international normalized ratio test and implications for monitoring of oral anticoagulant therapy. Clinical chemistry, 51(3), 561-568.
Yamashita, Y., Morimoto, T., Amano, H., Takase, T., Hiramori, S., Kim, K., & Command VTE Registry Investigators. (2019). Deep vein thrombosis in upper extremities: Clinical characteristics, management strategies and long-term outcomes from the Command VTE Registry. Thrombosis Research, 177, 1-9.
Zhao, Y., & Lv, G. (2013). Influence of temperature and storage duration on measurement of activated partial thromboplastin time, D‐dimers, fibrinogen, prothrombin time and thrombin time, in citrate‐anticoagulated whole blood specimens. International journal of laboratory hematology, 35(5), 566-570.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 V RANASINGHE, JPSM JAYASUNDARA, S. DE SILVA, Faiz Marikar, BMCRW YAPA
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Publishing your paper with Medical Laboratory Technology Journal (MLTJ) means that the author or authors retain the copyright in the paper. MLTJ granted an author(s) rights to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by MLTJ in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at private monetary gain or commercial advantage.
MLTJ journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets others remix, transform, and build upon the material for any purpose, even commercially. MLTJ journal Open Access articles are distributed under this Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA). Articles can be read and shared for All purposes under the following conditions:
BY: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.SA: If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.