Comparison of point-of-care versus central laboratory measurement of hematocrit, hemoglobin, and electrolyte concentrations
Abstract
Objectives We aimed to investigate the accuracy of certain laboratory examinations obtained by the ABG analyzer (ROCHE AVL OMNI S) as compared to hospital central laboratory (CL). Methods We prospectively collected data obtained from the same arterial blood sample regarding hematocrit, hemoglobin, potassium, and sodium. Results ABG analyzer results were significantly lower (p + and K + were within accepted by US Clinical Laboratory Improvement Amendment (USCLIA) differences (cut-off points) but not for Ht. In 8.0%, 17.5%, 37.5% and 56.0% of Hb, Na + , K + and Ht measurements respectively and 29.75% in sum the differences were over the USCLIA accepted limits. ABG analyzer significantly underestimate the values of Hb, Ht, Na + and K + , compared to CL and almost 30% of all examined parameters were beyond USCLIA accepted biases. Conclusions ABG analyzer significantly underestimates the values of Hb, Ht, Na + and K + compared to CL and almost 30% for all examined parameters are beyond USCLIA accepted biases. These data do not support widespread or even careful use of POCT for making diagnostic and treatment decisions until technology improves and results in improved outcomes.
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Spectrum bias may be present because the study cohort comprised only ED patients, who may differ from inpatient or ICU cohorts.
“Moreover, spectrum bias may be present, as ED patients may differ from inpatient or ICU cohorts in disease acuity and electrolyte disturbance profiles [6].”
These variables may cause systematic bias, especially in high-risk thresholds such as hyperkalemia (>5.5 mmol/L) or severe hyponatremia (<125 mmol/L).
“These variables may cause systematic bias, especially in high-risk thresholds such as hyperkalemia (> 5.5 mmol/L) or severe hyponatremia (< 125 mmol/L), where erroneous values could trigger inappropriate clinical responses [6].”
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References 27 · Cited by 38
- Authors
- Gavala, A., & Myrianthefs, P.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Myrianthefs, Pavlos
- Venue
- Heart & Lung
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 46
- Issue
- 4
- Pages
- 246-250
- ISSN
- 0147-9563 (ISSN-L)
- OpenAlex
- W2611010712
- Cited by
- 38
- References
- 27
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 7 · 2019: 5 · 2018: 6 · 2017: 1
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart & Lung (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- point-of-care testing, central laboratory comparison, hematocrit, hemoglobin, serum sodium, serum potassium, measurement accuracy
- MeSH terms
- Aged, Electrolytes, Emergency Medical Services, Female, Hematocrit, Hematologic Tests, Hemoglobins, Humans, Laboratories, Hospital, Male, Point-of-Care Systems
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