Could light meal jeopardize laboratory coagulation tests?
[1] Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy, Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy, Post-Graduate Program of Pharmaceutical Sciences, Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil,, CAPES Foundation, Ministry of Education of Brazil, Brasília - DF, Brazil, MERCOSUL: Sector Committee of Clinical Analyses and in Vitro Diagnostics – CSM 20, Rio de Janeiro, Brazil
[2] Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
[3] Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
[4] Post-Graduate Program of Pharmaceutical Sciences, Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil
[5] Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy, Post-Graduate Program of Pharmaceutical Sciences, Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil
Author notes:
[*] Corresponding author: dr.g.lima.oliveira@gmail.com
Background: Presently the necessity of fasting time for coagulation tests is not standardized. Our hypothesis is that this can harm patient safety. This study is aimed at evaluating whether a light meal (i.e. breakfast) can jeopardize laboratory coagulation tests.
Materials and methods: A blood sample was firstly collected from 17 fasting volunteers (12 h). Immediately after blood collection, the volunteers consumed a light meal. Then samples were collected at 1, 2 and 4 h after the meal. Coagulation tests included: activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fbg), antithrombin III (AT), protein C (PC) and protein S (PS). Differences between samples were assessed by Wilcoxon ranked-pairs test. The level of statistical significance was set at P < 0.05. Mean % differences were determined and differences between and baseline and 1, 2 and 4h samples were compared with reference change value (RCV).
Results: A significantly higher % activity of AT was observed at 1 h and 4 h after meal vs. baseline specimen [113 (104-117) and 111 (107-120) vs. 109 (102-118), respectively; P = 0.029 and P = 0.016]. APTT at 2 h was found significantly lower than baseline samples [32.0 (29.9–34.8) vs. 34.1 (32.2-35.2), respectively; P = 0.041]. The results of both Fbg and PS tests were not influenced by a light meal. Furthermore, no coagulation tests had significant variation after comparison with RCV.
Conclusion: A light meal does not influence the laboratory coagulation tests we assessed, but we suggest that the laboratory quality managers standardize the fasting time for all blood tests at 12 hours, to completely metabolize the lipids intake.
Keywords: diagnostic errors; fasting; postprandial period; reference values; reproducibility of results.
