Universität zu Köln

Dolscheid-Pommerich, Ramona C., Dolscheid, Sarah ORCID: 0000-0001-9104-6386, Grigutsch, Daniel, Stoffel-Wagner, Birgit and Graeff, Ingo (2016). Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital. PLoS One, 11 (11). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

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 (t(2547) = 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. McNemar's test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (male p<0.001; female p<0.001, total p<0.001). Hb-ZL resulted significantly more often in anemia diagnosis. In samples with Hb<8g/dl, McNemar's test yielded no significant difference (p = 0.169). In suprageriatric patients, McNemar's test revealed significant differences regarding anemia diagnosis according to WHO definition in male, female and total patients (male p<0.01; female 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dolscheid-Pommerich, Ramona C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dolscheid, Sarah UNSPECIFIED orcid.org/0000-0001-9104-6386 UNSPECIFIED Grigutsch, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffel-Wagner, Birgit UNSPECIFIED UNSPECIFIED UNSPECIFIED Graeff, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-255467
DOI:	10.1371/journal.pone.0166521
Journal or Publication Title:	PLoS One
Volume:	11
Number:	11
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ERROR; TIME; POCT Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25546