Wax David B, Reich David L
Department of Anesthesiology, Mount Sinai School of Medicine, New York City, New York 10029, USA.
Anesth Analg. 2007 Dec;105(6):1711-3, table of contents. doi: 10.1213/01.ane.0000286150.99529.f0.
Availability of point-of-care testing (POCT) technology may lead to unnecessary testing and expense without improving outcomes. We tested the hypothesis that frequency of intraoperative blood testing (IBT) would increase in association with installation of POCT devices in our surgical suites.
We performed a retrospective analysis of 38,115 electronic anesthesia records for cases performed in the 1 yr before and 1 yr after POCT installation. For each case, the frequency of IBT was tabulated and the change in frequency of IBT between the study periods was calculated for individual anesthesiologists, for the department as a whole, and for clusters of anesthetizing locations.
For the department as a whole, there was no significant change between the before and after study periods in the 13% proportion of cases in which IBT was obtained. For cases in which IBT was used, there was no significant increase in the number of IBTs per case.
We found no significant increase in the overall utilization of IBT associated with POCT presence in noncardiothoracic operating rooms.
即时检验(POCT)技术的应用可能会导致不必要的检测和费用增加,而不会改善治疗效果。我们检验了这样一个假设:在我们的手术室安装POCT设备后,术中血液检测(IBT)的频率会增加。
我们对POCT安装前1年和安装后1年进行的病例的38115份电子麻醉记录进行了回顾性分析。对于每个病例,统计IBT的频率,并计算个体麻醉医生、整个科室以及麻醉地点集群在研究期间IBT频率的变化。
对于整个科室而言,进行IBT的病例比例在研究前后均为13%,没有显著变化。对于使用IBT的病例,每例IBT的数量没有显著增加。
我们发现在非心胸外科手术室中,与POCT的存在相关的IBT总体利用率没有显著增加。