Appropriateness of point-of-care testing (POCT) in an emergency department

Background: Acute coronary syndrome is a major cause of death, morbidity and access in emergency departments (ED). Methods: We evaluated a point-of-care testing (POCT) for the determinations of cardiac markers in an emergency department (ED), defining the clinical efficiency (management of patient with chest pain) and economic effectiveness (rationalization of preanalytical phase) related to data of Core Lab. Results: The results of analytical performances showed a good correlation (cTnI r(2) = 0.89, myoglobin r(2) = 0.84, CK-MB r(2) = 0.9) between POCT and Core Lab and a significant decrease of the turn around time (TAT): difference of medians = -54 min, 95% Cl from -48 to -60 min. Conclusions: Our data confirmed that the accurate utilization of POCT in the ED assumes an effective triage of patient with chest pain and the improvement of preanalytical phase out of the laboratory (delivery of specimens) and within the laboratory reception, centrifugation. However, efficiency must be linked to methodological and quality control of the Core Lab, mainly through connectivity. (C) 2003 Elsevier Science B.V. All rights reserved.