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    Evaluation of analytical quality of coagulation parameters by sigmametric methodology
    (Kare Publishing, 2023) Aksit M.; Colak A.; Basok B.I.; Aksit M.Z.; Fidan M.; Kazar M.; Altan T.K.
    Objectives: The total testing process in the laboratory is divided into pre-analytical, analytical, and post-analytical phases. Evaluating the quality of these phases and carrying out improvement studies will increase the quality of the healthcare system. In this study, we aimed to evaluate the analytical phase of the coagulation tests using the six-sigma methodology, which is a quality management tool that aims at zero error. Methods: The coefficient of variation (CV%) values were calculated from the two-level internal quality control (IQC) data between January and June 2022 of the coagulation tests (prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer). External quality control (EQC) data were retrieved from the EQC program of external quality assurance services and used in the calculation of bias %. Total allowable error (TEa) data were obtained from the database of international organizations. The sigma value for each parameter was calculated according to the formula “(TEa%–Bias %)/ CV%.” Results: Level 1 and level 2 sigma values were calculated as 4.41 and 2.93 for PT; 5.27 and 4.31 for aPTT; 2.72 and 2.73 for fibrinogen, and 4.36 and 4.08 for D-dimer. Conclusion: Among coagulation tests in which we evaluated their analytical performances using the six sigma methodology, PT (level 2) and fibrinogen (level 1 and 2) showed poor performance (sigma value <3). We decided to follow the tests with 13s /22s /R4s /41s /8x Westgard control rules. Using these tests improvement can be achieved in the analytical process, and the overall testing process may improve by performing pre-analytical, post-analytical, and analytical assessments. © 2023, Kare Publishing. All rights reserved.
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    The relationship between ischemia-modified albumin/ albumin ratio levels and disease severity in COVID-19 patients
    (Kare Publishing, 2023) Aksit M.; Aksit M.Z.; Kazar M.; Caliskan T.; Senger S.S.; Akar H.; Ersan G.
    Objectives: In COVID-19 infection, oxidative stress occurs with the abnormal release of proinflammatory cytokines and the disruption of the balance between oxidants and antioxidants. In our study, we aimed to investigate the relationship between ischemia-modified albumin (IMA), a biomarker of oxidative stress, and the severity of the disease in hospitalized COVID-19 patients. Methods: One hundred and twenty-four hospitalized patients with a diagnosis of COVID-19 were included in the study. These patients were divided into critical and non-critical groups. Serum IMA levels were measured by the colorimetric albumin cobalt-binding method. The IMA-albumin ratio (IMAR) was calculated by dividing IMA values by albumin values. Results: The IMA and IMAR values of the critical COVID-19 group were statistically significantly higher than the non-critical group. In the multivariate analysis, the two variables IMAR and glucose were found to have the most important role in the severity of COVID-19 disease. For IMAR, the area under the ROC curve had a value of 0.725 (95% confidence interval 0.636–0.803). Conclusion: IMA and IMAR levels of the critical group were found to be higher than the non-critical group in COVID patients. We have observed that IMAR levels are associated with the severity of the disease and that IMAR is an independent prognostic risk factor for the disease. © 2023, Kare Publishing. All rights reserved.