Influence of centrifugation parameters on routine coagulation assays: a comparative study of prothrombin time, activated partial thromboplastin time, and the international normalized ratio

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Abstract Background: Coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (APTT), and the international normalized ratio (INR) are routinely employed to evaluate hemostatic function. Several strategies have been explored to shorten the turnaround time (TAT) for emergency coagulation testing, with most focusing on optimization of the pre-analytical phase. Materials and Methods: This retrospective study was conducted over 6 months in a tertiary care referral hospital to assess the impact of centrifugation speed on coagulation test results. A total of 64 citrated blood samples were divided into two equal aliquots. One aliquot was centrifuged at 3000 rpm for 15 min, while the other was centrifuged at 4000 rpm for 5 min. Within 10 min of centrifugation, plasma was evaluated for residual platelet counts using a Beckman Coulter LH750 analyzer. PT, APTT, and INR were subsequently measured using the ACL Elite Pro analyzer. Statistical analysis was performed using the student t test in Statistical Package for the Social Sciences version 29, with P < 0.05 considered statistically significant. Results: The mean PT values obtained at 3000 rpm and 4000 rpm were 20.32 s and 20.18 s, respectively ( P = 0.748). Mean APTT values were 30.68 s at 3000 rpm and 30.21 s at 4000 rpm ( P = 0.471). The mean INR values were 1.89 and 1.87 at 3000 rpm and 4000 rpm, respectively ( P = 0.739). A strong correlation was observed between results obtained under both centrifugation conditions, with no statistically significant differences in PT, APTT, or INR. Conclusion: High-speed centrifugation for the preparation of platelet-poor plasma is a reliable and safe approach for reducing laboratory TAT without adversely affecting the accuracy of coagulation test results.

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