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La Rivista Italiana della Medicina di Laboratorio 2020 Sep 14

DOI: 10.23736/S1825-859X.20.00068-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Safe use of the icteric index as possible diagnostic algorithm in the determination of bilirubin

Vincenzo ROCCAFORTE 1 , Massimo DAVES 2, Elvira INGLESE 1, Vanessa PROSERPIO 3, Flavia SCIARINI 3, Carlo Federico PERNO 1, Stefano PASTORI 1

1 Department of Laboratory Medicine, Area of Chemical Clinical Analysis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; 2 Clinical Biochemical Laboratory, Hospital of Bolzano, Bolzano, Italy; 3 Clinical Pathology Laboratory, Hospital Alessandro Manzoni, Lecco, Italy


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BACKGROUND: The main objective of this study was to evaluate the possible role of the I-index in creating an algorithm for measuring bilirubin, assessing patient safety and possible financial savings.
METHODS: We have extracted from the laboratory information system (LIS) all samples to which total bilirubin (TBIL) determination has been requested and icteric index (I-index) results in a 3- month period (i.e. between 1th October 2019 and 31th December 2019). The TBIL and I-index were measure on serum using the automated clinical chemistry analyzer Roche Cobas® 8000 c702. The correlation between the TBIL and I-index was assessed with the Spearman’s rank order test and Pearson’s test. Receiver operating characteristic curve (ROC) were constructed to explore the diagnostic performance of I-index value to discriminate between normal and abnormal bilirubin values (>1.2 mg/dl; >20.5 mmol/L).
RESULTS: An excellent correlation has been observed between TBIL and I-index (r= 0,985). ROC curve analysis constructed to explore the diagnostic performance of I-index value for detecting TBIL values above and below 1.20 mg/dL suggested that the most accurate I-index cut-off value was > 1. This cut-off showed an excellent diagnostic performance with the area under the curve of 0.975.
CONCLUSIONS: In conclusion, the results of our retrospective analysis confirm that I-index may provide useful information on real concentration of bilirubin and show the possibility use of the index in the formulation of diagnostic algorithm in the determination of bilirubin.


KEY WORDS: Icteric index; Total bilirubin; Detecting hyperbilirubinemia

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