60 Data-Driven Optimization of Tube Fill Requirements for PT and PTT on the Automated CS-5100 Coagulation Analyzer Article Swipe
Juan José Sánchez Ramírez
,
Julie Schmidt
,
Grace Thorsen
,
Anna Merrill
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/ajcp/aqaf121.487
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/ajcp/aqaf121.487
Underfilled blood tubes are a primary source of sample rejection in the clinical coagulation laboratory, leading to patient harm through unnecessary rejections that require additional blood draws and delay test results. The CS-5100 analyzer determines tube fill by measuring the distance (in mm) the probe travels along the Z-axis to reach plasma. In our laboratory, ordered tests are performed regardless of tube fill but are reported as “QNS” when the sample volume falls below default settings (i.e., 90% fill threshold). The aim of our study was to use retrospective tube fill and clotting time data from QNS samples that were promptly redrawn to establish the optimal tube fill for our patient population. Pairs of samples, in which the initial sample collected for PT and/or PTT was QNS according to default settings and the redrawn sample occurred within 4 hours, were collected over a 12-week period. Relative bias between redrawn and original results was evaluated as a function of time between blood draws, tube fill, sex, age, hematocrit, and, for PTT, whether it was ordered for heparin monitoring. Approximately 13,000 PT and PTT tests were performed during the 12-week period. For PT, 139 samples were QNS, and 108 were redrawn within 4 hours. For PTT, 145 samples were QNS, and 140 were redrawn within 4 hours. The average time to redraw was 66 minutes (range 23 – 228). The average bias between redrawn and QNS PT was -0.7 seconds (-3.1%); 94% of all PT sample pairs had a bias of less than 15%. The average bias between redrawn and QNS PTT was 0.5 seconds (2.5%); 72% of all PTT sample pairs had a bias of less than 15%. There was a statistically significant relationship between PT, but not PTT, bias and tube fill. No significant relationships were found between PT or PTT bias and hematocrit, time to redraw, sex, or age. PTTs ordered for heparin monitoring yielded a higher proportion of sample pairs with bias exceeding 15% relative to PTTs ordered for other purposes (38% vs. 21%). In our patient population, the default tube fill settings on the CS-5100 were overly restrictive for PT; decreasing the tube fill requirement by 10 mm would prevent 93% of PT rejections due to QNS yet still yield accurate results. The higher variability of PTT results, especially when performed for heparin monitoring, complicates retrospective optimization of tube fill requirements for PTT.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ajcp/aqaf121.487
- https://academic.oup.com/ajcp/article-pdf/164/Supplement_1/aqaf121.487/65271299/aqaf121.487.pdf
- OA Status
- bronze
- OpenAlex ID
- https://openalex.org/W7105192082
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W7105192082Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/ajcp/aqaf121.487Digital Object Identifier
- Title
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60 Data-Driven Optimization of Tube Fill Requirements for PT and PTT on the Automated CS-5100 Coagulation AnalyzerWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-11-01Full publication date if available
- Authors
-
Juan José Sánchez Ramírez, Julie Schmidt, Grace Thorsen, Anna MerrillList of authors in order
- Landing page
-
https://doi.org/10.1093/ajcp/aqaf121.487Publisher landing page
- PDF URL
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https://academic.oup.com/ajcp/article-pdf/164/Supplement_1/aqaf121.487/65271299/aqaf121.487.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/ajcp/article-pdf/164/Supplement_1/aqaf121.487/65271299/aqaf121.487.pdfDirect OA link when available
- Concepts
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Sample (material), Tube (container), Spectrum analyzer, Materials science, Biomedical engineering, Activated clotting time, Coagulation testing, Medicine, Clinical Practice, Hemostatics, Cartridge, Volume (thermodynamics), Heparin, Whole blood, Clotting time, Multiplex, Nuclear medicineTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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| abstract_inverted_index.PTT, | 170, 204, 288 |
| abstract_inverted_index.PTT. | 396 |
| abstract_inverted_index.PTTs | 311, 329 |
| abstract_inverted_index.QNS, | 195, 208 |
| abstract_inverted_index.age, | 166 |
| abstract_inverted_index.age. | 310 |
| abstract_inverted_index.and, | 168 |
| abstract_inverted_index.bias | 147, 230, 248, 255, 273, 289, 302, 324 |
| abstract_inverted_index.data | 95 |
| abstract_inverted_index.fill | 37, 63, 79, 91, 108, 344, 357, 393 |
| abstract_inverted_index.from | 96 |
| abstract_inverted_index.harm | 19 |
| abstract_inverted_index.less | 250, 275 |
| abstract_inverted_index.over | 142 |
| abstract_inverted_index.sex, | 165, 308 |
| abstract_inverted_index.test | 30 |
| abstract_inverted_index.than | 251, 276 |
| abstract_inverted_index.that | 23, 99 |
| abstract_inverted_index.time | 94, 159, 218, 305 |
| abstract_inverted_index.tube | 36, 62, 90, 107, 163, 291, 343, 356, 392 |
| abstract_inverted_index.were | 100, 140, 184, 194, 198, 207, 211, 296, 349 |
| abstract_inverted_index.when | 69, 383 |
| abstract_inverted_index.with | 323 |
| abstract_inverted_index.21%). | 336 |
| abstract_inverted_index.228). | 227 |
| abstract_inverted_index.Pairs | 113 |
| abstract_inverted_index.There | 278 |
| abstract_inverted_index.along | 47 |
| abstract_inverted_index.below | 74 |
| abstract_inverted_index.blood | 2, 26, 161 |
| abstract_inverted_index.delay | 29 |
| abstract_inverted_index.draws | 27 |
| abstract_inverted_index.falls | 73 |
| abstract_inverted_index.fill, | 164 |
| abstract_inverted_index.fill. | 292 |
| abstract_inverted_index.found | 297 |
| abstract_inverted_index.other | 332 |
| abstract_inverted_index.pairs | 245, 270, 322 |
| abstract_inverted_index.probe | 45 |
| abstract_inverted_index.reach | 51 |
| abstract_inverted_index.still | 372 |
| abstract_inverted_index.study | 85 |
| abstract_inverted_index.tests | 57, 183 |
| abstract_inverted_index.tubes | 3 |
| abstract_inverted_index.which | 117 |
| abstract_inverted_index.would | 362 |
| abstract_inverted_index.yield | 373 |
| abstract_inverted_index.(i.e., | 77 |
| abstract_inverted_index.(range | 224 |
| abstract_inverted_index.13,000 | 179 |
| abstract_inverted_index.Z-axis | 49 |
| abstract_inverted_index.and/or | 124 |
| abstract_inverted_index.draws, | 162 |
| abstract_inverted_index.during | 186 |
| abstract_inverted_index.higher | 318, 377 |
| abstract_inverted_index.hours, | 139 |
| abstract_inverted_index.hours. | 202, 215 |
| abstract_inverted_index.overly | 350 |
| abstract_inverted_index.redraw | 220 |
| abstract_inverted_index.sample | 9, 71, 120, 135, 244, 269, 321 |
| abstract_inverted_index.source | 7 |
| abstract_inverted_index.volume | 72 |
| abstract_inverted_index.within | 137, 200, 213 |
| abstract_inverted_index.(2.5%); | 264 |
| abstract_inverted_index.12-week | 144, 188 |
| abstract_inverted_index.CS-5100 | 33, 348 |
| abstract_inverted_index.average | 217, 229, 254 |
| abstract_inverted_index.between | 148, 160, 231, 256, 284, 298 |
| abstract_inverted_index.default | 75, 130, 342 |
| abstract_inverted_index.heparin | 176, 314, 386 |
| abstract_inverted_index.initial | 119 |
| abstract_inverted_index.leading | 16 |
| abstract_inverted_index.minutes | 223 |
| abstract_inverted_index.optimal | 106 |
| abstract_inverted_index.ordered | 56, 174, 312, 330 |
| abstract_inverted_index.patient | 18, 111, 339 |
| abstract_inverted_index.period. | 145, 189 |
| abstract_inverted_index.plasma. | 52 |
| abstract_inverted_index.prevent | 363 |
| abstract_inverted_index.primary | 6 |
| abstract_inverted_index.redraw, | 307 |
| abstract_inverted_index.redrawn | 102, 134, 149, 199, 212, 232, 257 |
| abstract_inverted_index.require | 24 |
| abstract_inverted_index.results | 152 |
| abstract_inverted_index.samples | 98, 193, 206 |
| abstract_inverted_index.seconds | 238, 263 |
| abstract_inverted_index.through | 20 |
| abstract_inverted_index.travels | 46 |
| abstract_inverted_index.whether | 171 |
| abstract_inverted_index.yielded | 316 |
| abstract_inverted_index.(-3.1%); | 239 |
| abstract_inverted_index.Abstract | 0 |
| abstract_inverted_index.Relative | 146 |
| abstract_inverted_index.accurate | 374 |
| abstract_inverted_index.analyzer | 34 |
| abstract_inverted_index.clinical | 13 |
| abstract_inverted_index.clotting | 93 |
| abstract_inverted_index.distance | 41 |
| abstract_inverted_index.function | 157 |
| abstract_inverted_index.occurred | 136 |
| abstract_inverted_index.original | 151 |
| abstract_inverted_index.promptly | 101 |
| abstract_inverted_index.purposes | 333 |
| abstract_inverted_index.relative | 327 |
| abstract_inverted_index.reported | 66 |
| abstract_inverted_index.results, | 381 |
| abstract_inverted_index.results. | 31, 375 |
| abstract_inverted_index.samples, | 115 |
| abstract_inverted_index.settings | 76, 131, 345 |
| abstract_inverted_index.according | 128 |
| abstract_inverted_index.collected | 121, 141 |
| abstract_inverted_index.establish | 104 |
| abstract_inverted_index.evaluated | 154 |
| abstract_inverted_index.exceeding | 325 |
| abstract_inverted_index.measuring | 39 |
| abstract_inverted_index.performed | 59, 185, 384 |
| abstract_inverted_index.rejection | 10 |
| abstract_inverted_index.“QNS” | 68 |
| abstract_inverted_index.additional | 25 |
| abstract_inverted_index.decreasing | 354 |
| abstract_inverted_index.determines | 35 |
| abstract_inverted_index.especially | 382 |
| abstract_inverted_index.monitoring | 315 |
| abstract_inverted_index.proportion | 319 |
| abstract_inverted_index.regardless | 60 |
| abstract_inverted_index.rejections | 22, 367 |
| abstract_inverted_index.Underfilled | 1 |
| abstract_inverted_index.coagulation | 14 |
| abstract_inverted_index.complicates | 388 |
| abstract_inverted_index.hematocrit, | 167, 304 |
| abstract_inverted_index.laboratory, | 15, 55 |
| abstract_inverted_index.monitoring, | 387 |
| abstract_inverted_index.monitoring. | 177 |
| abstract_inverted_index.population, | 340 |
| abstract_inverted_index.population. | 112 |
| abstract_inverted_index.requirement | 358 |
| abstract_inverted_index.restrictive | 351 |
| abstract_inverted_index.significant | 282, 294 |
| abstract_inverted_index.threshold). | 80 |
| abstract_inverted_index.unnecessary | 21 |
| abstract_inverted_index.variability | 378 |
| abstract_inverted_index.optimization | 390 |
| abstract_inverted_index.relationship | 283 |
| abstract_inverted_index.requirements | 394 |
| abstract_inverted_index.Approximately | 178 |
| abstract_inverted_index.relationships | 295 |
| abstract_inverted_index.retrospective | 89, 389 |
| abstract_inverted_index.statistically | 281 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 4 |
| citation_normalized_percentile.value | 0.77798106 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |