Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
POINT OF CARE TESTING - RANDOMIZED CONTROLLED TRIAL OF CLINICAL OUTCOME
Autore:
KENDALL J; REEVES B; CLANCY M;
Indirizzi:
FRENCHAY HOSP NHS TRUST BRISTOL BS16 1LE AVON ENGLAND UNIV BRISTOL,BRISTOL ROYAL INFIRM,DEPT ACCID & EMERGENCY MED BRISTOL BS2 8HW AVON ENGLAND UNIV BRISTOL,DEPT SOCIAL MED,RES & DEV SUPPORT UNIT BRISTOL BS8 2PR AVON ENGLAND
Titolo Testata:
BMJ. British medical journal
fascicolo: 7137, volume: 316, anno: 1998,
pagine: 1052 - 1057
SICI:
0959-8138(1998)316:7137<1052:POCT-R>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
OF-CARE; EMERGENCY; ANALYZER;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
J. Kendall et al., "POINT OF CARE TESTING - RANDOMIZED CONTROLLED TRIAL OF CLINICAL OUTCOME", BMJ. British medical journal, 316(7137), 1998, pp. 1052-1057

Abstract

Objectives: To describe the proportion of patients attending an accident and emergency department for whom blood analysis at the point of care brought about a change in management; to measure the extent to which point of care testing resulted in differences in clinical outcome for these patients when compared with patients whose samples were tested by the hospital laboratory. Design: Open, single centre, randomised controlled trial, Blood samples were randomly allocated to point of care testing or testing by the hospital's central laboratory. Setting: The accident and emergency department of the Bristol Royal Infirmary, alarge teaching hospital which cares fur an inner city population. Subjects: Representative sample of patients who attended the department between April 1996 and April 1997 and who required blood, tests, Data collection was structured in 8 hour blocks so that all hours of the dayand all days of the week were equally represented. Main outcome measures: The proportion of patients for whom point of care testing broughtabout a change in treatment in which timing was considered to be critical to clinical outcome. Mortality, the length of stay in hospital, admission rate, the amount of time spent waiting for results of blood tests, the amount of time taken to decide on management plans, and the amount of time patients spent in the department were compared between patients whose samples were tested at the point of care and those whose samples were sent to the laboratory.Results: Samples were obtained from 1728 patients. Changes in management in which timing was considered to be critical occurred in 59 out of 859 (6.9%, 95% confidence interval 5.3% to 8.8%) patients in the point of care arm of the trial, Decisions were made 74 minutes earlier (68 min to 80 min, P < 0.0001) whenpoint of care testing was used for haematological tests as compared to central laboratory testing, 86 minutes earlier (80 min to 92 min, P < 0.0001) for biochemical tests, and 21 minutes earlier (-3 min to 44 min, P = 0.09) for analyses of arterial blood gases, There were no differences between the groups in the amount of time spent in the department, length of stay in hospital, admission rates, or mortality. Conclusion: Point of care testing reduced the time taken to make decisions on patient management that were dependent on the results of blood tests, It also brought about Easter changes in treatment for which timing nas considered to be critical in about 7% of patients, These changes did not affect clinical outcome or the amount of time patients spent in the department.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/09/20 alle ore 01:04:15