为在辐射学部门的浆液 creatinine 的即时决心的一台手持 creatinine 测量设备的评估

• 作者: Alexandra Gutfleisch Christoph R Becker Claudia Meier Dieter Hannak Henrik J Michaely Joachim Brade Stefan Haneder Stefan O Schoenberg
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Contrast-medium-induced NEPHROPATHY Nephrogenic SYSTEMIC FIBROSIS Point of care testing Serum CREATININE determination StatSensor
• 年，卷（期）: 2012,（7）
• 页码范围: 328-334
• 页数: 7页
• 分类号: R318.6

摘要

AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination. METHODS: In this institutional review board-approved, prospective study, 401 patients referred for contrastenhanced computed tomography were included at two centres. Capillary (c)SCr was determined using two devices A+B and venous (v)SCr was determined in the centre’s laboratory. Method comparison statistics for both centres and for vSCr【】1.2 mg/dL, receiver operating characteristic analysis, negative predictive values (NPV), sensitivity and specificity were calculated pre-/ post-curve offset correction with vSCr. RESULTS: Pearson’s coefficients for cSCr vs vSCr were: centre 1-A:0.93/B:0.92; centre 2-A:0.85/B:0.82 (all P 【 0.0001). Overall correlation was better for vSCr 】 1.2 mg/dL. The area under the receiver operating characteristic curves showed a high accuracy for cSCr, but the device underestimated SCr, which was confirmed by Bland-Altman plot. Addition of the offset correction factor to the original data from centre 1 resulted in an improvement in sensitivity for detecting patients at risk (】 1.2 mg/dL), whilst maintaining acceptable specificity and improving NPV. CONCLUSION: This study showed the feasibility of SCr determination using the evaluated handheld device in a routine clinical setting. The device showed high sensitivity and high NPV, but may significantly underestimate SCr without offset correction to local laboratories.