Rapid Centrifugation for Coagulation Testing: A Multianalyzer Validation Study Harmonizing Preanalytical Protocols for Total Laboratory Automation.

OBJECTIVES

Centrifugation requirements differ between coagulation and clinical chemistry testing, potentially limiting workflow efficiency and total laboratory automation (TLA). Coagulation assays typically require standard centrifugation at 1500 g for 15 min, whereas chemistry samples use a rapid protocol at 2300 g for 5 min. This study evaluated the impact of rapid centrifugation on prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer results.

METHODS

Blood samples were prospectively collected from volunteers in 3, 2, and pediatric 1 mL citrate tubes and were processed using standard or rapid centrifugation. Testing was performed for PT, APTT, and D-Dimer on Sysmex CN3000 and ACL-TOP 750 analyzers, with residual platelet counts assessed.

RESULTS

A total of 130 samples were analyzed (41 from 3 mL tubes, 41 from 2 mL tubes, and 39 from 1 mL tubes). Rapid centrifugation produced significantly higher residual platelet counts than the standard protocol (39.2 × 109/L vs. 18.8 × 109/L, p < 0.0001). Strong correlations (r > 0.9) were observed for PT and APTT across analyzers, while D-dimer results on ACL-TOP 750 showed slightly lower correlation (r = 0.830). Bland-Altman analysis demonstrated small mean biases (< 1% for PT and APTT). D-dimer biases from CN3000 and ACL-TOP 750 were 1.06% and -2.70%, respectively, which remained within the predefined total allowable error. Residual platelets showed no impact on test results.

CONCLUSIONS

Rapid centrifugation at 2300 g for 5 min provides coagulation results comparable to the standard protocol and may facilitate integration of coagulation testing into TLA workflows.