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A Narrative Review on the Preanalytical Sample Errors in the Hematology Section of Clinical Laboratory

Asian Journal of Biological and Life Sciences,2023,12,2,230-236.
Published:September 2023
Author(s) affiliations:

Lissa Lourein Villanueva Lorque,* Kristel Aryanna Mendiola Bonifacio, Irish Gonzales Padilla, Marie Isabelle Sandoval Panganiban, Asela Gabrielle Arcangel Persia, Rochel Diaz Tsai, Reymund Miguel Mabbagu

School of Medical Laboratory Science, Far Eastern University – Dr. Nicanor Reyes Medical Foundation, PHILIPPINES.


Background: Various errors may occur during the preanalytical phase of laboratory testing and can introduce inaccuracies that can compromise test findings which creates a significant concern for both clinicians and patients. This narrative review aims to: (1) Determine the sources of the preanalytical error in the haematology section, (2) Identify the impact of these errors and (3) Enumerate the strategies to minimize these errors. Materials and Methods: The search for articles and journals was conducted between March 10, 2023 to March 12, 2023 using Google Scholar and PubMed as the database and the SANRA method as the instrumental tool for inclusion and exclusion criteria. Among the 161 total journal studies, 8 journals were considered and analysed in depth. Results: The most common preanalytical errors determined in this review are: insufficient blood samples, clotted blood samples, hemolyzed samples and other errors such as transportation delays and wrong patient information. Insufficient sample may prolong the clotting time, a low reading of haematocrit and MCV and a high MCHC. Whereas, overfilled samples may produce false positive results for polycythemia, thrombocytopenia, and leukopenia. A clotted sample causes damage to the cell and consumption of the coagulation factor which can affect readings on Complete Blood Count, Blood gases, Coagulation, and the Erythrocyte Sedimentation Rate. A hemolyzed sample affects tests for hemostasis considerably affecting the results of the Prothromin Time, activated Prothromin Time, D-dimer tests and the levels of antithrombin and fibrinogen. Conclusion: Insufficient phlebotomy skills and specimen preparation contribute to the different preanalytical errors that may cause erroneous results in haematology testing. These errors can result in patient misdiagnosis, incorrect treatment plans and poor patient outcomes. Proper specimen collection, handling and transportation should be done to minimize these preanalytic errors