Reliability of point-of-care testing of INR in acute stroke

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Theresa L GreenMichael D Hill

Abstract

In the emergency department, portable point-of-care testing (POCT) coagulation devices may facilitate stroke patient care by providing rapid International Normalized Ratio (INR) measurement. The objective of this study was to evaluate the reliability, validity, and impact on clinical decision-making of a POCT device for INR testing in the setting of acute ischemic stroke (AIS). A total of 150 patients (50 healthy volunteers, 51 anticoagulated patients, 49 AIS patients) were assessed in a tertiary care facility. The INR's were measured using the Roche Coaguchek S and the standard laboratory technique. The interclass correlation coefficient and 95% confidence interval between overall POCT device and standard laboratory value INRs was high (0.932 (0.69 - 0.78). In the AIS group alone, the correlation coefficient and 95% CI was also high 0.937 (0.59 - 0.74) and diagnostic accuracy of the POCT device was 94%. When used by a trained health professional in the emergency department to assess INR in acute ischemic stroke patients, the CoaguChek S is reliable and provides rapid results. However, as concordance with laboratory INR values decreases with higher INR values, it is recommended that with CoaguChek S INRs in the > 1.5 range, a s...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Aug 9, 2001·Anaesthesia·J HirschW Schaffartzik
Nov 17, 2001·Journal of Thrombosis and Thrombolysis·A M van den Besselaar
Apr 30, 2002·The Annals of Pharmacotherapy·Dawn E HavrdaCarrie M Marvin
Jul 5, 2003·BMJ : British Medical Journal·E T Murray, M Greaves
Sep 12, 2003·The New England Journal of Medicine·Elaine M HylekDaniel E Singer

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Citations

May 22, 2013·Current Atherosclerosis Reports·Jamsheed A Desai, Eric E Smith
May 18, 2013·Journal of Clinical Nursing·Eeva Liikanen, Liisa Lehto
Oct 27, 2017·Acta Neurologica Scandinavica·R ZenlanderA Berglund
Mar 15, 2011·Annals of Neurology·Silke WalterKlaus Fassbender

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