Posterske teme Poster topics - Biochemia Medica
Posterske teme Poster topics - Biochemia Medica
Posterske teme Poster topics - Biochemia Medica
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P22-3 Procjena analitičkih sustava<br />
jednost grupe, pričem se prihvatljivima smatraju oni koji<br />
se nalaze unutar dozvoljenog odstupanja od ±2 relativne<br />
standardne devijacije (SDI). U Zavodu za kliničku kemiju<br />
koncentracija mioglobina se određuje imunoturbidimetrijskom<br />
metodom na analizatoru Olympus AU 400,<br />
a rezultati se procjenjuju prema grupi ostalih metoda (4<br />
laboratorija). Koncentracija cTnI se određuje imunokemijskom<br />
(RPIA) metodom na analizatoru Dade Stratus CS, a<br />
rezultat se procjenjuje prema metodi RPIA (Dade Behring<br />
Stratus CS; 9 laboratorija). Procjena rezultata bez obzira<br />
na metodu je pokazala veliku varijabilnost (KV %): za mioglobin<br />
26,6% i za cTnI 77,7%. Grupiranje rezultata prema<br />
metodama je pokazalo manju varijabilnost: za mioglobin<br />
0,5–31,4% i za cTnI 3,6–20,7%. Varijabilnost rezultata<br />
grupe u kojoj se procjenjuju naši rezultati za mioglobin je<br />
bila 25,9%, što je očekivana vrijednost s obzirom na broj<br />
sudionika i heterogenost grupe. Varijabilnost rezultata za<br />
cTnI u grupi metoda RPIA je iznosila 6,1%, što je očekivana<br />
vrijednost s obzirom na homogenost grupe. S obzirom na<br />
visoku varijabilnost rezultata bez obzira na metodu neophodna<br />
je standardizacija metoda za cTnI primjenom metoda<br />
defi niranih vezanjem protutijela isključivo na epitope<br />
stabilnoga dijela molekule cTnI i KV manjim od 10%. Iako<br />
su rezultati za mioglobin usklađeniji, varijabilnost unutar<br />
pojedinih metoda nameće standardizaciju metoda za mioglobin<br />
prema certifi ciranom referentnom materijalu.<br />
E-mail: mariana.kardum@zg.htnet.hr<br />
P22-4<br />
Prijeanalitičke pogrješke u laboratorijskoj<br />
medicini: vrsta i učestalost<br />
Brkljačić V, Rogić D, Juričević V, Sertić J<br />
Klinički zavod za laboratorijsku dijagnostiku, Klinički bolnički centar<br />
Zagreb, Zagreb, Hrvatska<br />
Kvaliteta analitičkog materijala kritični je čimbenik za<br />
kvalitetu rezultata laboratorijskih pretraga. Kako bi se liječnicima<br />
osigurali kvalitetni nalazi treba poštivati pravila<br />
dobre laboratorijske prakse i uvesti strategiju za prevenciju<br />
pogrješke odgovornim usvajanjem standardiziranog<br />
prijeanalitičkog postupka. Nepoštivanje prijeanalitičkih<br />
standarda uzrok je za oko 93% pogrješaka u dijagnostičkom<br />
laboratorijskom testiranju. Cilj rada bila je obrada<br />
ukupnih podataka o prijeanalitičkim pogrješkama na<br />
uzorcima bolesnika u svrhu dobivanja uvida u njihovu<br />
učestalost i broj te uspostava strategije za njihovo smanjenje.<br />
Istraživanje je obuhvatilo 237 600 uzoraka bolesnika<br />
od kojih je 3307 obilježeno prijeanalitičkim pogrješkama,<br />
<strong>Biochemia</strong> <strong>Medica</strong> 2006;16(Suppl 1):S1–S268<br />
S220<br />
acceptable and satisfactory. Myoglobin concentrations<br />
were determined by immunoturbidimetric method<br />
(Olympus AU 400 analyzer) and results estimated within<br />
the group of other methods (4 participants). cTnI concentrations<br />
were determined by RPIA method (Dade Behring<br />
Stratus CS analyzer) and the results estimated within the<br />
group of RPIA method (9 participants). The results estimated<br />
irrespective of the method used showed high variability<br />
(CV %) for myoglobin and cTnI (26.6% and 77.7%,<br />
respectively). Variability of the results estimated within<br />
the group was lower: 0.5%-31.4% for myoglobin and<br />
3.6%- 20.7% for cTnI. The variability of myoglobin results<br />
within the group of other methods (25.9%) was quite expected<br />
because of the small number of participants and<br />
group heterogeneity. The variability of cTnI results within<br />
the group of RPIA methods (6.1%) was lower as the result<br />
of group homogeneity. Accordingly, harmonization of<br />
cTnI results is necessary due to the high variability of results<br />
estimated regardless of the method. That is why cTnI<br />
methods with antibodies on epitopes on the stable part<br />
of the molecule are recommended. Although the results<br />
for myoglobin showed a higher degree of harmonization,<br />
the variability within the methods imposes the need of<br />
harmonization according to the certifi ed reference material.<br />
E-mail: mariana.kardum@zg.htnet.hr<br />
P22-4<br />
Evaluation of analytical systems<br />
Preanalytical errors in laboratory medicine:<br />
type and frequency<br />
Brkljačić V, Rogić D, Juričević V, Sertić J<br />
Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital<br />
Center, Zagreb, Croatia<br />
The quality of analytical material is a factor critical for the<br />
quality of test results. To provide physicians with quality<br />
laboratory results, it is necessary to comply with the rules<br />
of good laboratory practice and to introduce strategy for<br />
error prevention by responsible adoption of standardized<br />
preanalytical procedure. Failure to comply with this<br />
standard is the cause of approximately 93% of errors in<br />
diagnostic laboratory testing. The aim of the study was to<br />
process all data on preanalytical errors in patient samples<br />
in order to get an insight in their frequency and number,<br />
and to establish a strategy for their reduction. The study<br />
included 237 600 patient samples; 3307 of them involved<br />
preanalytical errors, with 0.06%-2.4% relative frequency
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