EFFECT OF THE ORDER OF DRAW FOR MULTIPLE BLOOD COLLECTION TUBES ON DIAGNOSTIC PARAMETERS

Author(s)

Oláh A1, Müller Á1, Pakai A2, Szabó L1, Stromájer-Rácz T1, Knisz J1, Boncz I1, Betlehem J1, Csonti R1
1University of Pécs, Pécs, Hungary, 2University of Pécs, Zalaegerszeg, Hungary

OBJECTIVES:  There are numerous international standards and recommendations by pharmaceutical manufacturers for the order of draw to avoid contamination of the sample caused by additives in blood collection tubes. Our goal was to examine whether changing the order of draw results in biases in the analyzed diagnostic parameters. METHODS:  The quantitative, cross-sectional study was carried out in Karolina Hospital, Mosonmagyaróvár, Hungary between September 1. and November 31, 2016.We used non-randomized, purposive sampling in both experimental and control groups (N1=30, N2=30). In the experimental group, four incorrect orders of draw for phlebotomy tubes were used (Clot-activator, Na-citrate; Li-heparine, Na-citrate; K3 EDTA, native; Na-citrate, native). In the control group, the correct order of draw was followed (Na-cytrate, native, K3 EDTA). The following parameters were examined: prothrombin, INR, Potassium, Calcium, Magnesium, ALP. Data were analyzed using descriptive (absolute and relative frequencies, median with interquartile range [IQR]) and mathematical (χ2-test, Mann- Whitney U tests, linear and logistic regressions) statistics (p <0.05). RESULTS:  Incorrect order of draw (K3EDTA- serum tube) resulted in significantly decreased calcium levels in the experimental group compared to the control group (2.39 mmol/l [IQR: 2.33-2.46] vs. 2.60 mmol/l [IQR: 2.57-2.63], p <0,001) Any other deviation in the order of draw failed to show significant biases. CONCLUSIONS:  Incorrect order of draw for the sampling tubes during phlebotomy resulted in decreased level of calcium ion, which is a statistically significant difference, however, the value still remained in the normal clinical range.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PHP123

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Multiple Diseases

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