Comparison of PT and aPTT Results in Icteric Samples using Optical and Electromechanical Methods
DOI:
https://doi.org/10.37287/ijghr.v8i3.1122Keywords:
aPTT, electromechanical method, icteric sample, optical method, PTAbstract
Prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests are important screening tests for assessing coagulation pathway function and monitoring anticoagulant therapy. These tests use a coagulation analyzer with different detection methods, namely optical and electromechanical methods. The working principles of the two methods can cause variations in test results, especially in samples with icteric interference. Therefore, it is necessary to evaluate the comparison of PT and aPTT values in icteric samples using both methods. This study aimed to evaluate the differences in PT and aPTT values in icteric samples using optical and electromechanical methods. This study used a prospective analytical design with a cross-sectional approach, conducted at Adam Malik Hospital, Medan, from July to August 2025. A total of 69 samples that met the inclusion criteria were selected using sequential sampling techniques. Each sample is tested for PT and aPTT using optical and electromechanical methods. The results of each test were analyzed using the Mann-Whitney, Kappa, correlations tests, and Bland-Altman plots. Significant differences were observed in PT and aPTT values between the optical and electromechanical methods (p<0.001), while INR values showed no significant difference (p=0.426). Interpretation agreement was moderate for PT (κ=0.599; p<0.001) and strong for aPTT (κ=0.661; p<0.001). Despite numerical differences, both methods provided comparable clinical interpretations, and total bilirubin showed no association with PT or aPTT values. The optical and electromechanical methods produced comparable clinical interpretations despite differences in PT and aPTT values, and total bilirubin levels were not associated with PT or aPTT results.
References
Aggarwal, S., Nayak, D. M., & Manohar, C. (2014). Discrepancy in Optical & Mechanical Method in Coagulation Tests in a Turbid Sample. Indian Journal of Hematology and Blood Transfusion, 30(S1), 402–404. https://doi.org/10.1007/s12288-014-0438-5
Bellio, P., De Angelis, S., Piccirilli, A., Di Michele, G., Barnabei, R., Amicosante, G., Perilli, M., & Celenza, G. (2022). Evaluation of the Analytical Performances of the Biolabo SOLEA 100 Optical Coagulometer and Comparison with the Stago STA-R MAX Analyser in the Determination of PT, APTT, and Fibrinogen. Diagnostics, 13(1), 85. https://doi.org/10.3390/diagnostics13010085
Carta, M., Bonente, F., Teresa Comberlato, M., Pellizzari, T., Marotto, E., Marzari, E., & Giavarina, D. (2021). Evaluation of STA‐NeoPTimal, an extraction thromboplastin reagent with ISI close to 1. International Journal of Laboratory Hematology, 43(2), 311–317. https://doi.org/10.1111/ijlh.13365
DeLoughery, T. G. (2019). Hemostasis and Thrombosis: Fourth Edition. In Hemostasis and Thrombosis: Fourth Edition. Springer International Publishing. https://doi.org/10.1007/978-3-030-19330-0
Hernaningsih, Y., & Akualing, J. S. (2017). The effects of hemolysis on plasma prothrombin time and activated partial thromboplastin time tests using photo-optical method. Medicine (United States), 96(38). https://doi.org/10.1097/MD.0000000000007976
Hernaningsih, Y., & Butarbutar, T. V. (2019). The Effects of Plasma Prothrombine Time and Activated Partial Thromboplastin Time Based on Different Instruments and Methods. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2019/37999.13172
Jean, B. N., Clarisse, D., & Zephanie, N. (2020). Effect of haemolysis, icterus and lipemia on prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen measured using Sysmex CA- 50 Hemostasis Analyzer at La Croix du Sud Hospital. Journal of Clinical Immunology and Immunopathology Research, 10(1), 1–5. https://doi.org/10.5897/JCIIR2018.0084
Kristoffersen, A. H., Hollestelle, M. J., Cadamuro, J., Hillarp, A., Jennings, I., Marrington, R., Gidske, G., Kesseler, D., & Meijer, P. (2025). Practical handling of hemolytic, icteric and lipemic samples for coagulation testing in European laboratories. A collaborative survey from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM). Clinical Chemistry and Laboratory Medicine (CCLM), 63(10), 2074–2084. https://doi.org/10.1515/cclm-2025-0319
Lippi, G., Plebani, M., & Favaloro, E. J. (2013). Interference in coagulation testing: Focus on spurious hemolysis, icterus, and lipemia. Seminars in Thrombosis and Hemostasis, 39(3), 258–266. https://doi.org/10.1055/s-0032-1328972
Médica Boliviana, G. (2020). Prothrombin time and activated partial thromboplastin time usefulness in the preoperative assessment of hemostasis in pediatrics. https://www.redalyc.org/articulo.oa?id=445674705012
Nagant, C., Rozen, L., & Demulder, A. (2016). HIL Interferences on Three Hemostasis Analyzers and Contribution of a Preanalytical Module for Routine Coagulation Assays. Clinical Laboratory, 62(10/2016). https://doi.org/10.7754/Clin.Lab.2016.160313
Nougier, C., Jousselme, E., Sobas, F., Pousseur, V., & Négrier, C. (2020a). Effects of hemolysis, bilirubin, and lipemia interference on coagulation tests detected by two analytical systems. International Journal of Laboratory Hematology, 42(1), 88–94. https://doi.org/10.1111/ijlh.13147
Patologi Klinik, M., Alim Abdullah, A., Arif, M., & Bahar, B. (2012). INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY PENELITIAN Pemeriksaan Prothrombin Time dan Activated Partial Thromboplastin Time dengan Humaclot VA Serta Sysmex CA 500 (Prothrombin Time and Activated Partial Thromboplastin Time Test’s Result using Humaclot VA and Sysmex CA 500) Asosiasi HLA-DRB1* dan HLA-DQB1* dengan IgM-RF Serum pada Artritis Reumatoid (Association HLA-DRB1* and HLA-DQB1* with Serum IgM-RF on Rheumatoid Arthritis). 18(3).
Ramadhani, B. (2021). DIFFERENCES VALUE OF PT AND APTT IN EXAMINATION OF ELECTROMECHANICAL AND PHOTO-OPTICAL METHOD. Journal of Vocational Health Studies, 5(1), 17. https://doi.org/10.20473/jvhs.v5.i1.2021.17-21
Scalambrino, E., Faioni, E. M., Clerici, M., Avarello, I., Capecchi, M., Pasca, S., & Tripodi, A. (2023). Bilirubin color interference on prothrombin time and activated partial thromboplastin time tests assessed in patients with liver disease. Clinical Chemistry and Laboratory Medicine (CCLM), 61(12), e244–e247. https://doi.org/10.1515/cclm-2023-0393
Sommer, J., Buyue, Y., Bardan, S., Peters, R., Jiang, H., Kamphaus, G., Gray, E., & Pierce, G. (2014). Comparative field study: impact of laboratory assay variability on the assessment of recombinant factor IX Fc fusion protein (rFIXFc) activity. Thrombosis and Haemostasis, 112(11), 932–940. https://doi.org/10.1160/th13-11-0971
Tantanate, C., Teyateeti, M., & Tientadakul, P. (2011). Influence of Plasma Interferences on Screening Coagulogram and Performance Evaluation of the Automated Coagulation Analyzer Sysmex® CS-2100i. Original Article, 151–156.
Ülfer, G. (2025). A comparison of the optical method with the mechanical method in routine coagulation tests. Journal of Medical Biochemistry, 44(3), 479–485. https://doi.org/10.5937/jomb0-56100
Wong, W. H., Tan, C. W., Abdul Khalid, N. B., Dalimoenthe, N. Z., Yip, C., Tantanate, C., Lim, R. D., Kim, J. H., & Ng, H. J. (2023). Reagent Effects on the Activated Partial Thromboplastin Time Clot Waveform Analysis: A Multi-Centre Study. Diagnostics, 13(14), 2447. https://doi.org/10.3390/diagnostics13142447
Woolley, A., Golmard, J. ‐L., & Kitchen, S. (2016a). Effects of haemolysis, icterus and lipaemia on coagulation tests as performed on Stago STA‐Compact‐Max analyser. International Journal of Laboratory Hematology, 38(4), 375–388. https://doi.org/10.1111/ijlh.12498
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