Mirzazadeh Mehdi, Morovat Alireza, James Tim, Smith Ian, Kirby Justin, Shine Brian
Department of Clinical Biochemistry, John Radcliffe Hospital, Oxford, UK.
Emerg Med J. 2016 Mar;33(3):181-6. doi: 10.1136/emermed-2015-204669. Epub 2015 Sep 22.
Point-of-care testing allows rapid analysis of samples to facilitate prompt clinical decisions. Electrolyte and calcium abnormalities are common in acutely ill patients and can be associated with life-threatening consequences. There is uncertainty whether clinical decisions can be based on the results obtained from blood gas analysers or if laboratory results should be awaited.
To assess the agreement between sodium, potassium and calcium results from blood gas and laboratory mainstream analysers in a tertiary centre, with a network consisting of one referral and two peripheral hospitals, consisting of three networked clinical biochemistry laboratories.
Using the laboratory information management system database and over 11 000 paired samples in three hospital sites, the results of sodium, potassium and ionised calcium on blood gas analysers were studied over a 5-year period and compared with the corresponding laboratory results from the same patients booked in the laboratory within 1 h.
The Pearson's linear correlation coefficient between laboratory and blood gas results for sodium, potassium and calcium were 0.92, 0.84 and 0.78, respectively. Deming regression analysis showed a slope of 1.04 and an intercept of -5.7 for sodium, slope of 0.93 and an intercept of 0.22 for potassium and a slope of 1.23 with an intercept of -0.55 for calcium. With some strict statistical assumptions, percentages of results lying outside the least significant difference were 9%, 26.7% and 20.8% for sodium, potassium and calcium, respectively.
Most clinicians wait for the laboratory confirmation of results generated by blood gas analysers. In a large retrospective study we have shown that there is sufficient agreement between the results obtained from the blood gas and laboratory analysers to enable prompt clinical decisions to be made.
即时检验能够对样本进行快速分析，以助于做出及时的临床决策。电解质和钙异常在急性病患者中很常见，且可能伴有危及生命的后果。目前尚不确定临床决策能否基于血气分析仪获得的结果做出，还是应该等待实验室结果。
在一个由一家转诊医院和两家周边医院组成、包含三个联网临床生物化学实验室的三级中心，评估血气分析仪与实验室主流分析仪所测钠、钾和钙结果之间的一致性。
利用实验室信息管理系统数据库以及三个医院站点的11000多对配对样本，对5年期间血气分析仪所测钠、钾和离子钙的结果进行研究，并与同一患者在实验室1小时内登记的相应实验室结果进行比较。
实验室与血气分析仪所测钠、钾和钙结果之间的Pearson线性相关系数分别为0.92、0.84和0.78。Deming回归分析显示，钠的斜率为1.04，截距为 -5.7；钾的斜率为0.93，截距为0.22；钙的斜率为1.23，截距为 -0.55。在一些严格的统计假设下，钠、钾和钙超出最小显著差异结果的百分比分别为9%、26.7%和20.8%。
大多数临床医生会等待实验室对血气分析仪生成的结果进行确认。在一项大型回顾性研究中，我们表明血气分析仪与实验室分析仪所获结果之间有足够的一致性，能够做出及时的临床决策。
