CRITICAL VALUES OF HEMOSTASIS PARAMETERS IN AN ONCOLOGY CENTER: A RETROSPECTIVE REGISTRY-BASED STUDY.
Patients with cancer are at high risk of hemostatic disorders due to tumor-related mechanisms, antineoplastic therapy, and surgical interventions. Critical laboratory values (CVs) represent life-threatening conditions requiring immediate clinical response and are essential indicators of laboratory quality and patient safety.
To analyze the frequency, structure, and distribution of critical values of hemostasis parameters (APTT and fibrinogen) in the clinical diagnostic laboratory of an oncology center.
A retrospective study of the electronic CV registry was conducted for the period January-December 2025. Critical thresholds were defined according to SOPs and international recommendations. Data were analyzed by month, clinical ward, and type of hemostatic disorder. Comparative statistical analysis using the χ² test was performed. During the study period, a total of 48,326 coagulation tests were performed, including 27,418 APTT assays and 20,908 fibrinogen measurements. The overall frequency of critical values was 27.5 per 1,000 coagulation tests.
A total of 1,328 CVs were registered. The most frequent abnormalities were hypofibrinogenemia (<1.5 g/L) (60%), prolonged APTT (>78 s) (23%), and absent clot formation by APTT (10%). The distribution of CVs differed significantly across clinical departments (χ²(13)=726.51, p<0.001), with the highest burden observed in the hematobiochemistry department, ICU, and hematology wards. Extreme hypocoagulatory states (absence of clot formation by APTT or fibrinogen assays) accounted for 12% of all registered critical events, indicating a substantial proportion of patients at immediate risk of life-threatening hemorrhagic complications. Seasonal variation was statistically significant (χ²(10)=72.80, p<0.001), with peaks in March, July, and October.
Critical hemostasis abnormalities are highly prevalent in oncology patients and are predominantly associated with hypocoagulatory states. Implementation of a structured electronic CV reporting system enables rapid clinician notification, optimization of laboratory workflow, and improved patient safety in high-risk oncology settings.
To analyze the frequency, structure, and distribution of critical values of hemostasis parameters (APTT and fibrinogen) in the clinical diagnostic laboratory of an oncology center.
A retrospective study of the electronic CV registry was conducted for the period January-December 2025. Critical thresholds were defined according to SOPs and international recommendations. Data were analyzed by month, clinical ward, and type of hemostatic disorder. Comparative statistical analysis using the χ² test was performed. During the study period, a total of 48,326 coagulation tests were performed, including 27,418 APTT assays and 20,908 fibrinogen measurements. The overall frequency of critical values was 27.5 per 1,000 coagulation tests.
A total of 1,328 CVs were registered. The most frequent abnormalities were hypofibrinogenemia (<1.5 g/L) (60%), prolonged APTT (>78 s) (23%), and absent clot formation by APTT (10%). The distribution of CVs differed significantly across clinical departments (χ²(13)=726.51, p<0.001), with the highest burden observed in the hematobiochemistry department, ICU, and hematology wards. Extreme hypocoagulatory states (absence of clot formation by APTT or fibrinogen assays) accounted for 12% of all registered critical events, indicating a substantial proportion of patients at immediate risk of life-threatening hemorrhagic complications. Seasonal variation was statistically significant (χ²(10)=72.80, p<0.001), with peaks in March, July, and October.
Critical hemostasis abnormalities are highly prevalent in oncology patients and are predominantly associated with hypocoagulatory states. Implementation of a structured electronic CV reporting system enables rapid clinician notification, optimization of laboratory workflow, and improved patient safety in high-risk oncology settings.
Authors
Kozhakhmetova Kozhakhmetova, Yelemessova Yelemessova, Syzdykova Syzdykova, Abdullina Abdullina, Issatayeva Issatayeva, Turgambayeva Turgambayeva, Kamalbekova Kamalbekova, Zhumagaleyeva Zhumagaleyeva, Mussakhanova Mussakhanova
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