Effect of Haemolysis Interferences on Emergency Biochemistry Parameters in a Tertiary Care Hospital in New Delhi.

ABSTRACT

Haemolysis is the most common pre-analytical error encountered in biochemistry laboratories. Several clinical biochemistry laboratories have adopted individual policies regarding rejection of haemolysed samples. The aim of this study was to evaluate the effect of visible haemolysis on biochemistry parameters done in the emergency laboratory.METHODS150 blood samples (50 highly haemolysed, 50 slightly haemolysed and 50 no haemolysis) that were received in the Emergency Biochemistry laboratory of Safdarjung Hospital, New Delhi, were included in the current study. They were analysed for different biochemical parameters and the results compared. Statistical analysis was conducted using Microsoft Excel 2016. Data was presented as, number and median. Mann-U Whitney test was used to test any significant difference between the groups. p< 0.05 was considered to be significant.RESULTSNo significant change was seen in samples with slight haemolysis. However, values of potassium, total and direct bilirubin were significantly elevated (p-value-0.001, 0.002 and 0.015 respectively). Moreover, mean ALP was found to be 290±19.76 U/L in slightly haemolysed samples and 211±16.67 U/L in samples that are highly haemolysed (p=0.049). Therefore, there was a heterogeneous and unpredictable response to haemolysis observed for several parameters that prevents the adoption of reliable corrective measures for results on the basis of the visible haemolysis.CONCLUSIONSThe test values of slightly haemolysed samples can be reported as there is little interference seen. However, in case of highly haemolysed samples, values of ALP, potassium, total, and direct bilirubin should not be reported. Nevertheless, visual assessment is not a reliable method to identify haemolysis, free haemoglobin concentrations should be measured.