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Are mechanical and electromechanical methods accurately interchangeable for measuring plasma prothrombin time and activated partial thromboplastin time? A comparative analysis study and potential implication to cardiovascular disease Pranata, Fransiska Jaya; Notopuro, Paulus Budiono; Hajat, Arifoel
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.12

INTRODUCTION: The DT100 offers both optical and mechanical modes, with its mechanical mode showing better homogenization than the STAGO, but comparative study is limited. OBJECTIVES: The study aimed to evaluate the diagnostic accuracy of plasma Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) measurements using the DT100 and STAGO instruments. METHODS: Designated as a cross-sectional study, this study was conducted at RSUD Dr. Soetomo from October 2022 to January 2023. Venous blood samples with plasma citrate anticoagulant 0.109 M 3.2% were consecutively collected from hospitalized patients, and all samples underwent testing using both the DT100 in mechanical mode (DT100, TCoag Ireland Limited, Ireland) and the STAGO employing an electromechanical method (Compact Max3, STAGO, France). Statistical analysis included comparison using Paired t-test, Pearson correlation, and Bland-Altman analysis to assess agreement between the results obtained from the two instruments. RESULTS: The study included 51 patients. PT levels were significantly lower with the DT100 compared to STAGO (MD: -2.0; 95%CI: (-2.30) – (-1.3); p<0.0001), and showed a strong positive correlation between methods (r:0.9535; p<0.0001). However, Bland-Altman analysis for PT showed a bias of 1.84, with limits of agreement (3.30-0.37), indicating systematic differences and variability. APTT levels were significantly higher with DT100 compared to STAGO (MD:3.60; 95%CI: 2.13–5.07; p<0.0001), with a moderate positive correlation (r:0.6690; p<0.0001). For APTT, bias of Bland-Altman analysis was -3.60, with limits ((-9.84) – (2.64)), suggesting significant discrepancies and variability between methods. CONCLUSION: The study found significant variability in PT and APTT measurements between the DT100 and STAGO methods.

Are mechanical and electromechanical methods accurately interchangeable for measuring plasma prothrombin time and activated partial thromboplastin time? A comparative analysis study and potential implication to cardiovascular disease Pranata, Fransiska Jaya; Notopuro, Paulus Budiono; Hajat, Arifoel
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.12

INTRODUCTION: The DT100 offers both optical and mechanical modes, with its mechanical mode showing better homogenization than the STAGO, but comparative study is limited. OBJECTIVES: The study aimed to evaluate the diagnostic accuracy of plasma Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) measurements using the DT100 and STAGO instruments. METHODS: Designated as a cross-sectional study, this study was conducted at RSUD Dr. Soetomo from October 2022 to January 2023. Venous blood samples with plasma citrate anticoagulant 0.109 M 3.2% were consecutively collected from hospitalized patients, and all samples underwent testing using both the DT100 in mechanical mode (DT100, TCoag Ireland Limited, Ireland) and the STAGO employing an electromechanical method (Compact Max3, STAGO, France). Statistical analysis included comparison using Paired t-test, Pearson correlation, and Bland-Altman analysis to assess agreement between the results obtained from the two instruments. RESULTS: The study included 51 patients. PT levels were significantly lower with the DT100 compared to STAGO (MD: -2.0; 95%CI: (-2.30) – (-1.3); p<0.0001), and showed a strong positive correlation between methods (r:0.9535; p<0.0001). However, Bland-Altman analysis for PT showed a bias of 1.84, with limits of agreement (3.30-0.37), indicating systematic differences and variability. APTT levels were significantly higher with DT100 compared to STAGO (MD:3.60; 95%CI: 2.13–5.07; p<0.0001), with a moderate positive correlation (r:0.6690; p<0.0001). For APTT, bias of Bland-Altman analysis was -3.60, with limits ((-9.84) – (2.64)), suggesting significant discrepancies and variability between methods. CONCLUSION: The study found significant variability in PT and APTT measurements between the DT100 and STAGO methods.

The Difference in Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Lactate Levels Between Sepsis and Septic Shock Patients Who Died in The ICU Rachmawati, Dwi; Utariani, Arie; Notopuro, Paulus Budiono; Semedi, Bambang Pujo
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.64-71

Introduction: Sepsis and septic shock are organ dysfunctions caused by the dysregulation of the body's response to infection and are the most common causes of death. Objective: This study aims to describe the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate levels in patients with sepsis and septic shock who died in the Intensive Care Unit (ICU). Methods: An observational retrospective study was conducted by examining the medical record data of sepsis and sepsis shock patients who were hospitalized in the ICU of Dr. Soetomo General Academic Hospital Surabaya from January to December 2019. Results: The study sample was 28 patients: 16 with sepsis and 12 with septic shock. Fifteen patients (53.6%) were women. The patients' mean age was 53.18 ± 13.61 years, and most patients (8 patients, 28.6%) belonged to the late adult age group (36-45 years). The most common comorbidities were diabetes mellitus and hypertension (30.8%). The highest incidence of infection in both groups occurred in the lungs (42.9%). Most of the patients had high SOFA scores, in the moderate (7-9) to severe (â‰¥ 10) category (39.3%). Almost all patients (82.1%) were treated for less than one week. The hematological examination within the first 24 hours showed a leukocyte value of 16,995 (Leukocytosis) and a platelet value of 279,500 (Normal). The NLR of septic shock patients (31.38±55.61) was higher than the NLR of sepsis patients (23.75±22.87). The PLR of septic shock patients (534.02±1000.67) was lower than the PLR of patients (802.93±1509.89). Lastly, the lactate levels in septic shock patients (3.84±1.99) were higher than in sepsis patients (1.97±1.06). Conclusion: There were no significant differences in the NLR and PLR values "‹"‹between sepsis and septic shock patients, but there were significant differences in their initial lactate levels.

Correlation of Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio with Stunting in Children Stanpo, Gwyneth Trixie; Notopuro, Paulus Budiono; Widjaja, Nur Aisiyah
Journal of Biomedicine and Translational Research Vol 11, No 3 (2025): December 2025
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v11i3.28088

Background: Globally, stunting affected approximately 148 million children under five in 2022. Chronic infection contributes to stunting through immune hyperactivation and excessive cytokine release. Since anthropometric assessments are prone to errors and may not accurately reflect the underlying inflammatory status, common systemic inflammatory markers, such as the Neutrophil-Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR), can serve as alternatives. These markers are simple, affordable, and accessible in every health center.Objective: To analyze the correlation of NLR, MLR, and PLR with stunting.Methods: A cross-sectional study involving pediatric patients aged 1-5 years from the Nutrition and Metabolic Outpatient Clinic of Dr. Soetomo Regional Hospital in Surabaya from 2022 to 2023. Forty-one samples met the inclusion and exclusion criteria. Data on NLR, PLR, MLR, and other hematological variables were obtained from the patients' hematology profiles. Group differences, correlations, and diagnostic performance were analyzed using Kruskal–Wallis, Spearman, and ROC methods, respectively.Results: Forty-one subjects were obtained and divided into three groups: 21 (51.2%) normal, 10 (24.4%) stunted, and 10 (24.4%) severely stunted. RBC and lymphocytes significantly increased in normal patients, whereas neutrophils, platelets, NLR, MLR, and PLR significantly increased in severely stunted patients. NLR, MLR, and PLR differed significantly between normal and stunted children (p =<0.001; p =0.002; and p =<0.001, respectively) and showed positive correlations between the NLR (p =<0.001; r =0.687), MLR (p =<0.001; r =0.558), and PLR (p =<0.001; r =0.784) with stunting. At cutoff values of 0.844 (NLR), 88.527 (PLR), and 0.174 (MLR), their AUCs were 0.90, 0.95, and 0.82, with sensitivities of 75%, 80%, and 60%, respectively.Conclusion: NLR, MLR, and PLR significantly differ among normal, stunted, and severely stunted children, showing positive associations with stunting. These markers, particularly PLR, may serve as a practical screening tool, warranting further validation through larger studies.

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