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Editor-in-chief
Maria Stella Graziani
Deputy Director
Martina Zaninotto
Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali
EIC Assistant
Francesco Busardò
International Advisory Board
Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada
Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano
Responsible Editor
Giuseppe Agosta
Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091
BC: Articoli scritti da S Pasqualetti
Anemia acquisita da ospedalizzazione: il ruolo delle perdite di sangue a scopo diagnostico
Hospital-acquired anemia: the role of diagnostic blood loss
<p>Hospital-acquired anemia (HAA) is defined by a reduction of blood hemoglobin concentrations in hospitalized patients, in absence of bleeding episodes occurring during the hospital stay. One of the most important causes of HAA is the considerable amount of blood drawn for diagnostic purposes, which mainly affects critical patients in the intensive care units. Although usually underestimated by healthcare providers, HAA can be a significant problem, because it may increase the necessity of allogenic transfusions, the morbidity and mortality rates and healthcare costs. Strategies to minimize diagnostic blood loss should be implemented by both clinical wards and laboratories within wider patient blood management programs, with the aim of improving patient clinical outcome. These should include using small-volume test tubes, reduction of sample waste, optimization of testing frequency, early removal of central catheters and healthcare professional education.</p>
<p>The use of II as a front-line test for the preliminary identification of blood samples with abnormal TB concentrations was recently proposed. However, laboratories should validate this approach on their own analyzers. In this study we validated the diagnostic accuracy of II on the Abbott Architect c16000 platform. TB concentrations (diazo-based colorimetric assay) and corresponding II values (derived from absorbance measurements of samples diluted with saline) in heparinised plasma and serum samples were collected for a 3- month period. Linear regression analysis (LRA) (II vs. TB) was performed for both samples. The diagnostic performance of II to discriminate between abnormal (>1.2 mg/dL) and physiological TB concentrations was evaluated using the ROC curve analysis. The optimal II cut-off was selected at a negative predictive value (NPV) >99% for detection of abnormal TB values. TB and relative II were obtained from 18,486 serum and 3700 plasma samples. LRA showed a strong correlation between II and TB (serum: <em>r</em><sup>2</sup>=0.951; plasma: <em>r</em><sup>2</sup>=0.941). ROC curve analysis gave the following areas under the curve: serum, 0.948 (CI: 0.945-0.951), and plasma, 0.922 (CI: 0.913-0.930), showing the high accuracy of II for detecting abnormal TB on both sample types. An II ≤0.8 reliably excluded abnormal (>1.2 mg/dL) TB concentrations (serum, prevalence 25.4%: sensitivity 99.6%, NPV 99.7%; plasma, prevalence 16.7%: sensitivity 98.6%, NPV 99.4%). In our laboratory the use of an II value 0.8 as front-line test should allow the accurate “zero-cost” detection of samples with normal TB concentrations avoiding TB measurement in ~35% of serum and <span style="font-family:symbol">~</span>40% of plasma samples.</p>
Biochimica Clinica ; 39(1) 076-077 Lettere all'Editore - Letters to the Editor
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