Interpretation of canine and feline blood smears by emergency room personnel
Interpretation of canine and feline blood smears by emergency room personnel
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DOI：
10.1111/j.1939-165x.2010.00280.x
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发表时间：
2011-03-01
影响因子：
1.2
通讯作者：
Knoll, Joyce S.
中科院分区：
文献类型：
--
作者：
Lanaux, Travis M.;Rozanski, Elizabeth A.;Knoll, Joyce S.
背景：在兽医急诊实践中，血液涂片解释通常用于对动物进行快速实验室评估，但急诊室人员（ERP）血液涂片解释结果与训练有素的兽医临床病理学人员评估结果的准确性尚不清楚。目的比较ERP与临床病理人员的血液涂片评价。方法2008年9月至2009年7月期间，所有在福斯特小动物医院急诊室进行血涂片评估并经诊断实验室检测出CBC的动物均符合纳入研究的条件。评估血涂片的ERP完成了标准表格，包括白细胞和血小板计数的估计以及红细胞和白细胞形态的评估。将现场评估结果与兽医诊断实验室报告的自动或手动结果进行比较。结果共评价了155份血涂片。ERP估计的血小板计数与自动计数之间有中等程度的一致性（kappa值为0.63；95%可信区间[CI]: 0.52, 0.74）。ERP估计的白细胞计数与自动计数之间不太一致（kappa值，0.48;95% CI: 0.37, 0.60）。具有较高临床意义的特异性异常，如毒性改变、有核红细胞、球细胞、血液寄生虫和淋巴母细胞，无法通过ERP预测。结论犬、猫血涂片的serp解释应谨慎使用，不应取代兽医诊断实验室的评估。
BackgroundInterpretation of blood smears is commonly used to provide rapid laboratory evaluation of animals in veterinary emergency practice, but the accuracy of results of blood smear interpretation by emergency room personnel (ERP) compared with evaluation by trained veterinary clinical pathology personnel is unknown.ObjectiveThe goal of this study was to compare blood smear evaluation by ERP with that of clinical pathology personnel.MethodsAll animals that had a CBC determined by a diagnostic laboratory and had blood smears evaluated by personnel at the Foster Hospital for Small Animals Emergency Room between September 2008 and July 2009 were eligible for study inclusion. ERP who evaluated blood smears completed standardized forms with estimates of the WBC and platelet counts and evaluation of RBC and WBC morphology. Results from point-of-care assessment were compared with automated or manual results reported by the veterinary diagnostic laboratory.ResultsOne hundred and fifty-five blood smears were evaluated. There was moderate agreement (kappa value, 0.63; 95% confidence interval [CI]: 0.52, 0.74) between estimated platelet counts by ERP and automated counts. Poor agreement was found between estimated WBC counts by ERP and automated counts (kappa value, 0.48; 95% CI: 0.37, 0.60). Specific abnormalities with a high likelihood of clinical significance, eg, toxic change, nucleated RBCs, spherocytes, hemoparasites, and lymphoblasts, were not predictably identified by ERP.ConclusionsERP interpretation of canine and feline blood smears should be used cautiously and should not replace evaluation by a veterinary diagnostic laboratory.