Point of Care D-Dimer Testing in the Emergency Department: A Bioequivalence Study
Annals of Laboratory Medicine
;
: 34-38, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-119343
ABSTRACT
BACKGROUND:
D-dimer is used widely as a diagnostic aid in low- and moderate-risk patients with suspected venous thromboembolism (VTE). While our laboratory utilizes VIDAS D-dimer analyzer (bioMerieux SA, France), our emergency department (ED) recently procured a D-dimer analyzer AQT90 FLEX (Radiometer Medical ApS, Denmark) for point of care testing (POCT) to facilitate patient management. We aimed to determine whether the time taken to receive D-dimer results using the 2 different analyzers differed significantly and to quantify the limits of agreement between the results of the 2 methods measured on the same patient.METHODS:
Adult patients presenting to the ED and requiring diagnostic workup for suspected VTE were included in this prospective observational study. Patients underwent simultaneous D-dimer measurements using the 2 different analyzers.RESULTS:
The paired results from 104 patients were analyzed. The median time for the D-dimer results from triage by VIDAS was 258 min (Inter-quartile range [IQR], 173-360) and by POCT was 146 min (IQR, 55-280.5); the median time difference was 101.5 min (IQR, 82-125.5). On an average, POCT D-dimer values were 15% lower on the same sample (limits of agreement, 34-213%). POCT predicted 83% of VIDAS positive results (sensitivity, 83.3% [95% confidence interval (CI), 70.4-91.3%]; specificity, 100% [95% CI, 93.6-100%]). All patients with positive imaging were identified correctly by both methods.CONCLUSIONS:
POCT delivers D-dimer results in significantly shorter turnaround times than pathology services; however, poor bioequivalence between VIDAS and POCT raises the issue of acceptability for use in the ED.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Kit de Reagentes para Diagnóstico
/
Fatores de Tempo
/
Produtos de Degradação da Fibrina e do Fibrinogênio
/
Tomografia Computadorizada por Raios X
/
Estudos Prospectivos
/
Sensibilidade e Especificidade
/
Sistemas Automatizados de Assistência Junto ao Leito
/
Serviço Hospitalar de Emergência
/
Tromboembolia Venosa
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Annals of Laboratory Medicine
Ano de publicação:
2013
Tipo de documento:
Artigo
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