Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
Department of Clinical Virology, Institute of Virology, University Hospital Muenster, 48149, Muenster, Germany.
Eur J Trauma Emerg Surg. 2023 Feb;49(1):487-493. doi: 10.1007/s00068-022-02091-x. Epub 2022 Sep 6.
To evaluate the accuracy and cost benefit of a rapid molecular point-of-care testing (POCT) device detecting COVID-19 within a traumatological emergency department.
Despite continuous withdrawal of COVID-19 restrictions, hospitals will remain particularly vulnerable to local outbreaks which is reflected by a higher institution-specific basic reproduction rate. Patients admitted to the emergency department with unknown COVID-19 infection status due to a- or oligosymptomatic COVID-19 infection put other patients and health care workers at risk, while fast diagnosis and treatment is necessary. Delayed testing results in additional costs to the health care system.
From the 8th of April 2021 until 31st of December 2021, all patients admitted to the emergency department were tested with routine RT-PCR and rapid molecular POCT device (Abbott ID NOW™ COVID-19). COVID-19-related additional costs for patients admitted via shock room or emergency department were calculated based on internal cost allocations.
1133 rapid molecular tests resulted in a sensitivity of 83.3% (95% CI 35.9-99.6%), specificity of 99.8% (95% CI 99.4-100%), a positive predictive value of 71.4% (95% CI 29-96.3%) and a negative predictive value of 99.9% (95% CI 99.5-100%) as compared to RT-PCR. Without rapid COVID-19 testing, each emergency department and shock room admission with subsequent surgery showed additional direct costs of 2631.25€, without surgery of 729.01€.
Although rapid molecular COVID-19 testing can initially be more expensive than RT-PCR, subsequent cost savings, improved workflows and workforce protection outweigh this effect by far. The data of this study support the use of a rapid molecular POCT device in a traumatological emergency department.
评估一种快速分子即时检测（POCT）设备在创伤急诊部门检测 COVID-19 的准确性和成本效益。
尽管 COVID-19 限制不断放宽，但医院仍将特别容易受到局部爆发的影响，这反映在特定机构的基本繁殖率较高。由于 COVID-19 感染的症状轻微或无症状，因此患者在急诊部门入院时 COVID-19 感染状况未知，这使其他患者和医护人员面临风险，而快速诊断和治疗是必要的。延迟检测会导致医疗系统的额外成本。
从 2021 年 4 月 8 日至 2021 年 12 月 31 日，所有收入急诊部门的患者均接受常规 RT-PCR 和快速分子 POCT 设备（雅培 ID NOW™ COVID-19）检测。根据内部成本分配，计算收入急症室或急诊部门的患者因 COVID-19 而产生的额外成本。
1133 次快速分子检测的敏感性为 83.3%（95%CI 35.9-99.6%），特异性为 99.8%（95%CI 99.4-100%），阳性预测值为 71.4%（95%CI 29-96.3%），阴性预测值为 99.9%（95%CI 99.5-100%），与 RT-PCR 相比。如果没有快速 COVID-19 检测，每个收入急诊部门和急症室并随后接受手术的患者会增加 2631.25 欧元的直接成本，无需手术则增加 729.01 欧元。
尽管快速分子 COVID-19 检测最初可能比 RT-PCR 更昂贵，但随后的成本节约、改善的工作流程和劳动力保护远远超过了这一影响。本研究的数据支持在创伤急诊部门使用快速分子 POCT 设备。
