Zierk, Jakob, Baum, Hannsjorg, Bertram, Alexander, Boeker, Martin ORCID: 0000-0003-2972-2042, Buchwald, Armin, Cario, Holger, Christoph, Juergen, Fruehwald, Michael C., Gross, Hans-Juergen, Groening, Arndt, Gscheidmeier, Thomas, Hoff, Torsten, Hoffmann, Reinhard, Klauke, Rainer, Krebs, Alexander, Lichtinghagen, Ralf, Muehlenbrock-Lenter, Sabine, Neumann, Michael, Noellke, Peter, Niemeyer, Charlotte M., Ruf, Hans-Georg, Steigerwald, Udo, Streichert, Thomas, Torge, Antje, Yoshimi-Noellke, Ayami, Prokosch, Hans-Ulrich, Metzler, Markus ORCID: 0000-0002-4523-1676 and Rauh, Manfred (2021). High-resolution pediatric reference intervals for 15 biochemical analytes described using fractional polynomials. Clin. Chem. Lab. Med., 59 (7). S. 1267 - 1279. BERLIN: WALTER DE GRUYTER GMBH. ISSN 1437-4331

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Abstract

Objectives: Assessment of children's laboratory test results requires consideration of the extensive changes that occur during physiological development and result in pronounced sex- and age-specific dynamics in many biochemical analytes. Pediatric reference intervals have to account for these dynamics, but ethical and practical challenges limit the availability of appropriate pediatric reference intervals that cover children from birth to adulthood. We have therefore initiated the multi-center data-driven PEDREF project Next-Generation Pediatric Reference Intervals) to create pediatric reference intervals using data from laboratory information systems. Methods: We analyzed laboratory test results from 638,683 patients (217,883-982,548 samples per analyte, a median of 603,745 test results per analyte, and 10,298,067 test results in total) performed during patient care in 13 German centers. Test results from children with repeat measurements were discarded, and we estimated the distribution of physiological test results using a validated statistical approach (kosmic). Results: We report continuous pediatric reference intervals and percentile charts for alanine transaminase, aspartate transaminase, lactate dehydrogenase, alkaline phosphatase, y-glutamyl-transferase, total protein, albumin, creatinine, urea, sodium, potassium, calcium, chloride, anorganic phosphate, and magnesium. Reference intervals are provided as tables and fractional polynomial functions (i.e., mathematical equations) that can be integrated into laboratory information systems. Additionally, Z-scores and percentiles enable the normalization of test results by age and sex to facilitate their interpretation across age groups. Conclusions: The provided reference intervals and percentile charts enable precise assessment of laboratory test results in children from birth to adulthood. Our findings highlight the pronounced dynamics in many biochemical analytes in neonates, which require particular consideration in reference intervals to support clinical decision making most effectively.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Zierk, JakobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baum, HannsjorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertram, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boeker, MartinUNSPECIFIEDorcid.org/0000-0003-2972-2042UNSPECIFIED
Buchwald, ArminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cario, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Christoph, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fruehwald, Michael C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gross, Hans-JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groening, ArndtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gscheidmeier, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoff, TorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, ReinhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klauke, RainerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krebs, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lichtinghagen, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muehlenbrock-Lenter, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neumann, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Noellke, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Niemeyer, Charlotte M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruf, Hans-GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steigerwald, UdoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Streichert, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Torge, AntjeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yoshimi-Noellke, AyamiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Prokosch, Hans-UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Metzler, MarkusUNSPECIFIEDorcid.org/0000-0002-4523-1676UNSPECIFIED
Rauh, ManfredUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-601685
DOI: 10.1515/cclm-2020-1371
Journal or Publication Title: Clin. Chem. Lab. Med.
Volume: 59
Number: 7
Page Range: S. 1267 - 1279
Date: 2021
Publisher: WALTER DE GRUYTER GMBH
Place of Publication: BERLIN
ISSN: 1437-4331
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Medical Laboratory TechnologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60168

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