目的:比较即时凝血分析仪(POCCA)与参考实验室凝血分析仪(LabCA)的准确性,并评估可能改变POCCA性能的混杂因素。
方法:前瞻性,观察性研究。
方法:两所大学兽医教学医院。
方法:在2020年4月至2021年6月期间,有43只客户拥有的狗接受了凝血测试。
方法:从接受凝血测试的狗中获取样品,作为诊断检查的一部分。在POCCA和LabCA上测量凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)。PCV,血小板计数,血浆总蛋白,高胆红素血症,溶血,血脂血症,并记录自凝集。
结果:在POCCA和LabCA之间,PT呈中等相关性,aPTT呈强相关性(PT:0.59,P<0.0001;aPTT:0.71,P<0.0001)。对于38个PT中的30个和37个aPTT中的33个,POCCA结果与正常或低凝样品一致。由LabCA确定。PCV为30%-55%的样本具有中等相关性(PT:0.63,P=0.0004;aPTT:0.63,P=0.0003),但是那些在该范围之外的人更有可能在POCCA上注册错误消息或提供不同的结果。当出现溶血时,PT的POCCA和LabCA之间存在弱相关性(rho:0.38[95%置信区间:0.19-0.76],P=0.18)和aPTT的强相关性(rho:0.86[95%置信区间:0.62-0.95],P<0.0001)。高胆红素血症的样本与PT密切相关(0.97,P=0.002),但与aPTT无关。未观察到血脂和自身凝集。
结论:PCV患者在制造商推荐的参考范围内存在可接受的相关性;然而,对PCV超出参考范围的样品的测量结果与LabCA不一致。在有凝血病和贫血或其他潜在混杂因素的患者中使用POCCA时应谨慎。
OBJECTIVE: To compare the accuracy of a point-of-care coagulation analyzer (POCCA) with a reference laboratory coagulation analyzer (LabCA) and to evaluate for confounding factors that could alter the performance of the POCCA.
METHODS: Prospective, observational study.
METHODS: Two university veterinary teaching hospitals.
METHODS: Forty-three client-owned dogs undergoing coagulation testing between April 2020 and June 2021.
METHODS: Samples were obtained from dogs undergoing coagulation testing as part of a diagnostic workup. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured on the POCCA and on the LabCA. PCV, platelet count, total plasma protein, hyperbilirubinemia, hemolysis, lipemia, and autoagglutination were recorded.
RESULTS: Moderate correlation was seen for PT and strong correlation was seen for aPTT between the POCCA and the LabCA (PT: 0.59, P < 0.0001; aPTT: 0.71, P < 0.0001). The POCCA results were consistent with normal or hypocoagulable samples for 30 of 38 PT and 33 of 37 aPTT results, as identified by the LabCA. Samples with PCV of 30%-55% were moderately correlated (PT: 0.63, P = 0.0004; aPTT: 0.63, P = 0.0003), but those outside that range were more likely to register an error message on the POCCA or provide disparate results. When hemolysis was present, there was a weak correlation between the POCCA and the LabCA for PT (rho: 0.38 [95% confidence interval: 0.19-0.76], P = 0.18) and a strong correlation for aPTT (rho: 0.86 [95% confidence interval: 0.62-0.95], P < 0.0001). Samples with hyperbilirubinemia were strongly correlated for PT (0.97, P = 0.002) but not for aPTT. Lipemia and autoagglutination were not observed.
CONCLUSIONS: There was an acceptable correlation in patients with PCV within the manufacturer\'s recommended reference range; however, measurements on samples with PCV outside the reference range were inconsistent with the LabCA. Caution should be used when using the POCCA in patients with coagulopathy and anemia or other potential confounders.