title: Clinical, operational and economic outcomes of point-of-care blood gas analysis in COPD patients.
abstract: BACKGROUND
  Arterial blood gas analysis is relevant in chronic obstructive pulmonary disease (COPD) management. The aim of this study was to evaluate whether the use of a blood gas analyzer in pulmonology departments improves the clinical, operational and economic outcomes when compared with clinical laboratory measurements.
  
  
  METHODS
  It is an observational prospective study. 112 patients were selected. After specimen collection, the measurement was performed both in pulmonology office as point-of-care and in laboratory. We evaluated clinical outcomes (modification of the indication of long-term oxygen therapy (LTOT) according to results, changes in blood gas analysis results, relationship of the partial pressure of oxygen (PaO2) obtained in the medical visit and velocity of change of the PaO2, influence of total haemoglobin concentration and the change in PaO2), operational outcomes (turnaround time (TAT) from specimen collection to receiving the blood gas analysis report) and economic outcomes (overall cost per process of patient care).
  
  
  RESULTS
  There were discrepancies in the indication of LTOT in 13.4% of patients. All parameters showed changes. PaO2 levels showed changes in 2 ways, though they frequently increase over time. The correlation was not good in the other two clinical outcomes. The median TATs in pulmonology office were 1 min versus 79 in laboratory, with 52 min for specimen preparation and transport and 17 min for TAT intralaboratory. The overall cost for the 112 patients in pulmonology office and laboratory was 16,769.89€ and 22,260.97€ respectively.
  
  
  CONCLUSIONS
  The use of a blood gas analyzer in a pulmonology office improves clinical, operational and economic outcomes when compared with clinical laboratory.
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain. Electronic address: paloma.oliver@gmail.com.
authors.forename: Paloma
authors.initials: P
authors.lastname: Oliver
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Buno
authors.affiliation: Department of Pneumology, La Paz University Hospital, Madrid, Spain.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alvarez-Sala
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Fernandez-Calle
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Alcaide
authors.affiliation: Department of Pneumology, La Paz University Hospital, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Casitas
authors.affiliation: Department of Pneumology, La Paz University Hospital, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Garcia-Quero
authors.affiliation: Department of Research and Biomedical Statistics, La Paz University Hospital, Madrid, Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Madero
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: Ruben
authors.initials: R
authors.lastname: Gomez-Rioja
authors.affiliation: Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Iturzaeta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000191:economics; D019095:Point-of-Care Systems; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D016896:Treatment Outcome
keywords: Blood gas analysis; Chronic obstructive pulmonary disease; Health economics; Patient outcome; Point of care system