Valoración del uso del índice ictérico como parámetro para la gestión de la determinación de la bilirrubina total

Carrión, R.A. Torrado; Chacón, Luz del Mar Rivas; Hernández, Verónica; Ruiz, Marta; Durán, Tomás Pascual

doi:10.1016/j.labcli.2018.12.002

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…Regarding the second objective of this study, we set I-index cut-off with the highest specificity and lowest false positive results, finding similar results than others studies with I-index ≥ 34.2 µmol/L (16)(17)(18). Hyperbilirubinemia diagnosis could be important in these cases to know the subjacent aetiology, such as Gilbert syndrome, hepatocellular damage, biliary obstruction, haemolytic anaemia, or others (12).…”

Section: Discussionsupporting

confidence: 64%

“…To our knowledge, this is the first study that evaluates I-index on Alinity c. It is well known that the icteric index is correlated to total bilirubin but we checked it in our platform (16)(17)(18)(19). Several studies have been published with the objective of reducing number of TBil tests with two main platforms, Roche and Abbott (16)(17)(18)(19)(20)(21). An interesting study of HIL index in these two platforms showed an unacceptable comparability between them (15).…”

Section: Discussionmentioning

confidence: 99%

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Utility of icteric index in clinical laboratories: more than a preanalytical indicator

Mondéjar

Reyes

Madrid

et al. 2021

Biochem. med. (Online)

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Introduction: Total bilirubin tests are highly demanded in clinical laboratories. Since icteric index (I-index) has zero cost, we aimed to evaluate its clinical utility and cost-effectiveness to determine if total bilirubin is necessary to be tested. We took into account if haemolysis could interfere to icteric index determination. Material and methods: Retrospectively we reviewed I-index results in two cohorts (43,372 and 8507 non-haemolysed and haemolysed samples, respectively). All determinations were done using Alinity c chemistry analysers (Abbott Diagnostics). Receiver operating characteristic (ROC) curve was used to determine the optimal index cut-off to discriminate between normal and abnormal bilirubin concentration (20.5 µmol/L). Results: The ROC curve analysis suggested 21.4 µmol/L as the optimal I-index cut-off but differences in sensitivity and specificity were detected between patient derivation. For rejecting purpose, 15.4 µmol/L and 17.1 µmol/L I-index thresholds were selected based on patient derivation (inpatients and emergency room; and primary care and outpatients, respectively) with 97% sensitivity and 0.25% false negative results. Sensitivity was much lower in haemolysed samples. We selected 34.2 µmol/L I-index as threshold to detect hyperbilirubinemia with 99.7% specificity and 0.26% false positive results, independent of haemolysis. With the icteric index cut-offs proposed, we would save 66% of total bilirubin requested and analyse total bilirubin in around 2% of samples without total bilirubin requested. Conclusions: This study supports the use of I-index to avoid bilirubin determination and to identify patients with hyperbilirubinemia. This work considers that the economic and test savings could help to increase the efficiency in clinical laboratories.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Utility of icteric index in clinical laboratories: more than a preanalytical indicator

Mondéjar

Reyes

Madrid

et al. 2021

Biochem. med. (Online)

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“…One of the main objectives of a clinical laboratory is to inform exact and accurate values, since the results of the tests requested to the laboratory influence between 60-70% of medical decisions [1].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2020

BJSTR

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One of the main objectives of a clinical laboratory is getting accurate values. To quantify the hemolysis, the study of hemolytic index is a widespread practice. Due to a change of analyzers, the present hemolysis interference study is aiming to quantify the possible change in 73 tests performed by different techniques in such equipment: spectrophotometry, indirect potentiometric and immunological techniques. The tests were performed in Roche Diagnostics Cobas 8000 equipment following the protocol of the Spanish Society of Laboratory Medicine (SEQCml). The results were compared with those reported in the inserts provided by Roche Diagnostics of the different techniques. Interference was obtained for the following compounds: amylase, aspartate aminotransferase (AST), direct bilirubin (DBil), creatinine kinase (CK), alkaline phosphatase (ALP), iron, lactate dehydrogenase (LDH), lipase, phosphorus, potassium, triglycerides, folate, ultrasensitive troponin T (hs-cTnT), insulin and parathyroid hormone (PTH). Working with new analyzers, it is important to study the interference of the hemolysis on different analytical techniques, as it has an impact on the medical decision making. In clinical practice, it is recommended to determine the hemolytic index, to detect and quantify the interference by hemolysis, assessing the possible rejection of samples and providing reliable reports helping clinicians to interpret the results.

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Valoración del uso del índice ictérico como parámetro para la gestión de la determinación de la bilirrubina total

Cited by 2 publications

References 5 publications

Utility of icteric index in clinical laboratories: more than a preanalytical indicator

Utility of icteric index in clinical laboratories: more than a preanalytical indicator

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