Rabani Hadas, Sheikh-Ahmad Mohammad, Sachner Robert, Yosefia Sawsan, Yeiches Michal, Chen-Konak Limor, Henig Clara, Dakwar Balsam, Shalata Anan, Jovanovic Katya, Rosenblat Ilana, Laniado Monica, Matter Ibrahim, Saiegh Leonard
Endocrinology Unit, Bnai Zion Medical Center, 47 Eliyahu Golomb Boulevard, Haifa 31048, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 31096, Israel.
Diagnostics (Basel). 2024 Nov 29;14(23):2692. doi: 10.3390/diagnostics14232692.
: To assess success rates and cost-effectiveness of adrenal venous sampling (AVS) after implementing point-of-care rapid cortisol (RC) testing conducted using a europium nanoparticle-based fluoro-immunoassay in patients with primary hyperaldosteronism. : A retrospective review of AVS procedures was conducted at our medical center between January 2016 and June 2024. The primary objective was to compare the success rates of AVS before and after the implementation of the RC testing. Secondary outcomes included a cost-benefit analysis. : Of 55 AVS procedures, 19 were conducted using RC testing and 36 were in the historical control cohort. The success rates for right vein sampling were 79% and 67%, respectively. Overall, in six (31.5%) patients in the RC cohort, a low RC selectivity index (SI) value, calculated within 10 min, enabled determination of unsuccessful cannulation and need for resampling during the same AVS session. Repeated sampling resulted in successful procedures in two cases (10.5%) and unsuccessful AVS in four cases, nonetheless sparing the need for repeated AVS sessions in 31.5% of cases. Utilizing RC potentially spared 6 patients from repeated AVS sessions, and considering the additional expenses on the RC test, its use afforded cost savings of an average of $1288 per patient. : We demonstrated the cost-effectiveness of utilizing RC measurement in sparing the need for repeated AVS sessions. RC measurement during AVS enabled identification of correct catheter placement in real time, allowing for prompt decisions regarding the need for additional sampling attempts, thereby reducing subsequent costs of repeated AVS sessions.
评估在原发性醛固酮增多症患者中使用基于铕纳米颗粒的荧光免疫测定法进行即时快速皮质醇（RC）检测后肾上腺静脉采样（AVS）的成功率和成本效益。：2016年1月至2024年6月在我们的医疗中心对AVS程序进行了回顾性研究。主要目的是比较RC检测实施前后AVS的成功率。次要结果包括成本效益分析。：在55例AVS程序中，19例使用RC检测，36例在历史对照队列中。右静脉采样的成功率分别为79%和67%。总体而言，在RC队列的6例（31.5%）患者中，在10分钟内计算出的低RC选择性指数（SI）值能够确定插管失败以及在同一AVS过程中需要重新采样。重复采样导致2例（10.5%）程序成功，4例AVS失败，但在31.5%的病例中避免了重复AVS过程的需要。使用RC可能使6例患者免于重复AVS过程，考虑到RC检测的额外费用，其使用平均为每位患者节省了1288美元。：我们证明了使用RC测量在避免重复AVS过程方面的成本效益。AVS期间的RC测量能够实时识别正确的导管位置，从而能够迅速决定是否需要额外的采样尝试，从而降低后续重复AVS过程的成本。
