title: A Retrospective Analysis of Clinical Laboratory Interferences Caused by Frequently Administered Medications in Burn Patients.
abstract: The goal of this study is to quantify the number of medications administered to burn patients and identify potential drugs interfering with laboratory testing. The authors reviewed the medical records of 12 adult (age ≥ 18 years) burn patients with more than 20% TBSA burns from an existing glucose control database at our institution. Dose, interval, and route of medications administered from admission to discontinuation of intensive insulin therapy were recorded. Interfering drugs were identified based on established clinical chemistry literature. The retrospective cohort of adult burn patients exhibited a mean (SD) age of 37.9 (3.0) years. Mean TBSA burn was 51.3 (9.3)%. Disease severity determined by the average multiple organ dysfunction score was 5.4 (0.2). Mean and median medications administered per day were 42.1 (9.5) and 49 (with a daily range of 0-65), respectively. A total of 666 potential laboratory test interferences caused by medications were identified. There were 261 different effects (eg, increased glucose, decreased potassium). Multiple interferences, 71.0% (475/666), were caused by more than one medication. Investigation of the number of medications administered to a burn patient and delineation of potential laboratory test interferences has not been conducted in burn patients. Given the substantial number of medications administered to burn patients, physicians and laboratory personnel should work together to identify potential interferences and define appropriate countermeasures while enhancing the laboratorians understanding of this unique population. This synergistic partnership can lead to intelligent support tools and potentially autocorrecting instruments.
authors.affiliation: From the *Department of Pathology and Laboratory Medicine, †Division of Burn Surgery, Department of Surgery, University of California, Davis, School of Medicine; and ‡Shriners Hospital for Children of Northern California, Sacramento.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Godwin
authors.forename: Kelly
authors.initials: K
authors.lastname: Lima
authors.forename: David
authors.initials: D
authors.lastname: Greenhalgh
authors.forename: Tina
authors.initials: T
authors.lastname: Palmieri
authors.forename: Soman
authors.initials: S
authors.lastname: Sen
authors.forename: Nam K
authors.initials: NK
authors.lastname: Tran
mesh_terms: D000328:Adult; D002053:Burn Units; D002056:Burns / Q000188:drug therapy* / Q000378:metabolism*; D019411:Clinical Laboratory Techniques; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies