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. 2021 Dec 14;60(3):408-432.
doi: 10.1515/cclm-2021-0853. Print 2022 Feb 23.

Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg

Ingo Mrosewski  1 , Tobias Dähn  1 , Jörg Hehde  1 , Elena Kalinowski  1 , Ilona Lindner  1 , Thea Marie Meyer  1 , Michael Olschinsky-Szermer  1 , Jana Pahl  1 , Monika Puls  1 , Kristin Sachse  1 , Rafael Switkowski  1
Affiliations

Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg

Ingo Mrosewski et al. Clin Chem Lab Med. .

Abstract

Objectives: Establishing direct reference intervals (RIs) for pediatric patients is a very challenging endeavor. Indirectly determined RIs can address this problem by utilization of existing clinical laboratory databases. In order to provide better laboratory services to the local pediatric population, we established population-specific hematology RIs via data mining.

Methods: Our laboratory information system (LIS) was searched for pediatric blood counts of patients aged from 0 days to 18 years, performed from 1st of January 2018 until 31st of March 2021. In total, 27,554 blood counts on our SYSMEX XN-9000 were initially identified. After application of pre-defined exclusion criteria, 18,531 sample sets remained. Age- and sex-specific RIs were established in accordance with International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and Clinical & Laboratory Standards Institute (CLSI) recommendations.

Results: When compared to pediatric RIs supplied by other authors, the RIs determined specifically for pediatric patients from Berlin and Brandenburg showed several relevant differences, especially with regard to white blood cell counts (WBCs), red blood cell counts (RBCs), red cell distribution widths (RDW) and platelet counts (PLTs) within the distinct age groups. Additionally, alterations to several published age-specific partitions had to be made, while new sex-specific partitions were introduced for WBCs and PLTs.

Conclusions: Generic RIs from textbooks, manufacturer information and medical publications - even from nationwide or multicenter studies - commonly used in many laboratories might not reflect the specifics of local patient populations properly. RIs should be tailored to the serviced patient population whenever possible. Careful data mining appears to be suitable for this task.

Keywords: data mining; hematology; indirect reference range; pediatric; reference interval (RI); reference range.

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