A point-of-care chemistry test for reduction of turnaround and clinical decision time.
OBJECTIVE
Our study compared clinical decision time between patients managed with a point-of-care chemistry test (POCT) and patients managed with the traditional central laboratory test (CLT).


METHODS
This was a randomized controlled multicenter trial in the emergency departments (EDs) of 5 academic teaching hospitals. We randomly assigned patients to POCT or CLT stratified by the Emergency Severity Index. A POCT chemistry analyzer (Piccolo; Abaxis, Inc, Union City, Calif), which is able to test liver panel, renal panel, pancreas enzymes, lipid panel, electrolytes, and blood gases, was set up in each ED. Primary and secondary end point was turnaround time and door-to-clinical-decision time.


RESULTS
The total 2323 patients were randomly assigned to the POCT group (n = 1167) or to the CLT group (n = 1156). All of the basic characteristics were similar in the 2 groups. The turnaround time (median, interquartile range [IQR]) of the POCT group was shorter than that of the CLT group (14, 12-19 versus 55, 45-69 minutes; P < .0001). The median (IQR) door-to-clinical-decision time was also shorter in the POCT compared with the CLT group (46, 33-61 versus 86, 68-107 minutes; P < .0001). The proportion of patients who had new decisions within 60 minutes was 72.8% for the POCT group and 12.5% for the CLT group (P < .0001).


CONCLUSIONS
A POCT chemistry analyzer in the ED shortens the test turnaround and ED clinical decision times compared with CLT.
Lee
Eui Jung
EJ
Seoul Emergency Medical Information Center, Seoul 110-744, South Korea.
Shin
Sang Do
SD
Song
Kyoung Jun
KJ
Kim
Seong Chun
SC
Cho
Jin Seong
JS
Lee
Seung Chul
SC
Park
Ju Ok
JO
Cha
Won Chul
WC
D019411:Clinical Laboratory Techniques; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D012720:Severity of Illness Index; D013997:Time Factors