A-185 Impact Assessment of Centrifugation During Transportation on Examination Results
Authors: Dias C , Zampieri G , Oliveira D C , Bonato C , Brochi L 
Published: October 2024

Abstract

Background
Laboratories are increasingly challenged to seek solutions to expedite the collection process and provide more convenience to patients. This study aims to validate the centrifugation of samples in transport cars for home collections without need to return to the basic unit after each sample collection for centrifugation using the traditional method for up to 2 hours, as recommended in the literature, providing an increase in the number of patient appointments and a greater portfolio of exams.

Methods
The study was carried out evaluating measurands that represent different methodologies and sample stability challenges, namely, PTH, free T4, testosterone, CA19.9, anti-HBS, anti-transglutaminase, LDH, potassium, glucose, sodium and alkaline phosphatase( FAL). The centrifuge used during sample transport was the Drucker, model Horizon - 6 Flex, calibrated and monitored during the study. Forty samples from volunteer patients were analyzed, with one tube centrifuged in the equipment installed in the car and a second tube in the basic unit's centrifuge within 2 hours of collection, both respecting the 30-minute clot retraction period. All tubes were sent to the same laboratory for execution.

Results
Throughout the study period, the calibration of the car's centrifuge remained stable. In the correlation, the variance, calculated by the F Test, showed an adequate result, below 1.69. The difference between the means of the test method and the comparative method calculated through the T Test was below the Critical T. The Pearson correlation for the mensurands Free T4, CA19.9, anti-transglutaminase, LDH, potassium, sodium and glucose was lower than the accepted limit of 0.950. Agreement analysis and Kappa index were performed and the data were evaluated from a qualitative point of view by the medical team, who considered the differences to have no clinical impact on the patient. PTH, CA19.9 and FAL were approved by the difference graph.In relation to glucose, the correlation between the serum-gel tube and fluoride was also evaluated, where we obtained lower results with the fluoride tube due to hemolysis caused by the additive. During the analysis of LDH results, a tendency to decrease the concentration of its dosages over time can be observed, and in this case there were lower results in samples centrifuged in the basic unit, due to the longer interval between collection and centrifugation.

Conclusions
After evaluation from a pre-analytical, quality and medical point of view, centrifugation from home samples collection directly in the car will allow a greater number of patients to be served, as there will be no need to return to the basic unit for centrifugation every 2 hours. It will also bring greater safety in centrifuging the sample at the correct time, avoiding any delays that may occur, mitigating potential deviations in results and greater process efficiency as the collector will not need to return to the basic unit for centrifugation, right during During the collection route, the samples will already be prepared for sending directly to the execution site. For glucose and LDH tests, it was possible to observe efficiency gains due to centrifugation 30 minutes after collection.