A single center study: the effect of in vitro lipemia on coagulation tests

OBJECTIVE: Coagulation tests like prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, international normalized ratio (INR), and D-dimer are vital for monitoring anticoagulant therapy and diagnosing blood disorders. Preanalytical factors such as lipemia, caused by high blood lipid levels after eating, lipid infusions, or metabolic diseases like diabetes, can affect test accuracy. In emergency departments, nonfasting samples increase lipemia risk. This study investigates how lipemia influences coagulation test results to improve diagnostic reliability in clinical settings. MATERIAL AND METHOD: Serial dilutions of 10% Oliclinomel parenteral lipid emulsion were prepared, and 1 ml of each dilution was mixed with plasma samples from 36 patients. The plasma pool was analyzed for PT, aPTT, fibrinogen, INR, and D-dimer using a Sysmex CS2500 analyzer, with triglyceride (TG) concentrations and lipemia index (LI) values measured by a Roche Cobas 6000 C501 analyzer. Bias (%) values were calculated and compared to target bias (%) values to determine cut-off LI values for each parameter. RESULTS: Results showed that PT and fibrinogen were affected by higher TG concentrations, while aPTT was influenced by lower TG concentrations. The cut-off LI values for PT, aPTT, and fibrinogen were determined to be 300, 50, and 150, respectively. For D-dimer, the cut-off LI value was established at 1200. CONCLUSION: These findings highlight the importance of determining specific LI cut-off values for each laboratory and considering lipemia's effect on coagulation test results, particularly in emergency settings and in patients with dyslipidemia.