Department of Emergency and Critical Care, University of Georgia, Athens, Georgia, USA.
Department of Emergency and Critical Care, University of Missouri, Columbia, Missouri, USA.
J Vet Emerg Crit Care (San Antonio). 2024 Sep-Oct;34(5):446-454. doi: 10.1111/vec.13416. Epub 2024 Sep 3.
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.
Prospective, observational study.
Two university veterinary teaching hospitals.
Forty-three client-owned dogs undergoing coagulation testing between April 2020 and June 2021.
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.
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.
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.
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。
前瞻性观察研究。
两所大学兽医教学医院。
43 只接受凝血检测的患犬，于 2020 年 4 月至 2021 年 6 月期间进行检测。
从接受凝血检测的犬中获取样本，作为诊断性检查的一部分。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）。记录红细胞压积（PCV）、血小板计数、总血浆蛋白、高胆红素血症、溶血、脂血和自身凝集。
POCCA 与 LabCA 之间的 PT 呈中度相关，aPTT 呈强相关（PT：0.59，P<0.0001；aPTT：0.71，P<0.0001）。对于 38 个 PT 和 37 个 aPTT 结果中的 30 个，POCCA 结果与 LabCA 确定的正常或低凝样本一致。PCV 为 30%-55%的样本中度相关（PT：0.63，P=0.0004；aPTT：0.63，P=0.0003），但不在该范围内的样本更有可能在 POCCA 上显示错误消息或提供不一致的结果。当存在溶血时，PT 时 POCCA 与 LabCA 之间呈弱相关（rho：0.38[95%置信区间：0.19-0.76]，P=0.18），而 aPTT 呈强相关（rho：0.86[95%置信区间：0.62-0.95]，P<0.0001）。高胆红素血症样本的 PT 呈强相关（0.97，P=0.002），但 aPTT 无相关性。未观察到脂血和自身凝集。
在制造商推荐的参考范围内，PCV 内的患者相关性可接受；然而，PCV 参考范围外的样本测量结果与 LabCA 不一致。在患有凝血障碍和贫血或其他潜在混杂因素的患者中使用 POCCA 时应谨慎。
