Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care HospitalReport as inadecuate




Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital - Download this document for free, or read online. Document in PDF available to download.

Fulfilling the requirements of point-of-care testing POCT training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin Hb determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices POCT-Hb were compared with Hb measurements performed at the central laboratory Hb-ZL. Additionally, sub collectives WHO anemia classification, patients with Hb <8 g-dl and suprageriatric patients age >85y. were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant r = 0.96, p<0.001. Mean difference was -0.44g-dl. POCT-Hb values tended to be higher than Hb-ZL values t2547 = 36.1, p<0.001. Standard deviation of the differences was 0.62 g-dl. Only in 26 patients 1%, absolute differences >2.5g-dl occurred. McNemars test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients ♂ p<0.001; ♀ p<0.001, total p<0.001. Hb-ZL resulted significantly more often in anemia diagnosis. In samples with Hb<8g-dl, McNemars test yielded no significant difference p = 0.169. In suprageriatric patients, McNemars test revealed significant differences regarding anemia diagnosis according to WHO definition in male, female and total patients ♂ p<0.01; ♀ p = 0.002, total p<0.001. The difference between Hb-ZL and POCT-Hb with Hb<8g-dl was not statistically significant <8g-dl, p = 1.000. Overall, we found a highly significant correlation between the analyzed hemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.



Author: Ramona C. Dolscheid-Pommerich , Sarah Dolscheid, Daniel Grigutsch, Birgit Stoffel-Wagner, Ingo Graeff

Source: http://plos.srce.hr/



DOWNLOAD PDF




Related documents