Stability of complete blood count parameters depends on the storage temperature, storage time, transport position and selected stability criterion

Abstract

Purpose: To evaluate stability of CBC parameters in samples containing K-3-EDTA in Hema&Tube brand evacuated tubes stored at 4 degrees C and room temperature in upright, horizontal and upside-down transport positions for up to 240 min by comparing with different stability criteria.Methods: A total of 450 outpatient samples, 75 for each condition, were stored for 240 min. Blood samples were analyzed at baseline, 60th, 120th and 240th min of storage time using Sysmex (R) XT-4000i hematology analyzer. CBC results were compared according to the paired samplest-test, one CV% change, CVI, BV DES 2014, RCPA, IQMH, EFLM Biological Variation 2019, ESfEQAand CLIA stability criteria.Results: In all transport conditions, almost all CBC parameters were unstable according to the paired samplest-test. Based on one CV % change RBC, hemoglobin, hematocrit, RDW-CV, neutrophils, platelets, MPV, PDW and plateletcrit were unstable in some transport conditions. However, most parameters were stable at all conditions, except especially for MCH, MPV, PDW and plateletcrit, while just MPV and PDW were unstable at RT in all transport conditions according to the lower and higher CVI, respectively.Conclusions: Paired samplest-test and one CV% change stability criteria are not suitable for decision. Clinical laboratories should establish the impact of storage time, storage temperature and transport positions for each CBC parameter while paying attention to the brand of evacuated tube according to the lower CVI of biological variation data stability criteria since it is more related to the impact of analysis deviation on clinical decisions to prevent misdiagnosis.