# Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross‐Sectional Study, 2023

## TL;DR

This study found that many blood samples in South Gonder hospitals were clotted or hemolyzed, affecting accurate diagnosis and patient care.

## Contribution

The study identifies specific pre-analytical factors associated with compromised blood samples in Ethiopian hospitals.

## Key findings

- 35.6% of samples were clotted, and 11.5% were hemolyzed.
- Clotting was linked to contamination, inadequate volume, and improper collection techniques.
- Poor sample quality can lead to diagnostic errors and increased healthcare costs.

## Abstract

Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre‐analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia.

This institutionally based cross‐sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor's specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random.

Among the 2331 test samples, 829 (35.6%) were clotted, and 269 (11.5%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture.

On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs.

This study, conducted in South Gonder hospitals in Ethiopia, investigated the prevalence and causes of clotted and hemolyzed blood samples submitted for hematological testing. The findings revealed a high rate of sample quality issues, with significant associations identified between pre‐analytical factors like collection technique and sample integrity. The conclusion emphasizes the substantial impact of these compromised samples on patient care, potentially leading to diagnostic errors and adverse outcomes.