Implementation of Alere i Influenza A & B point of care test for the diagnosis of influenza in an ED
Implementation of Alere i Influenza A & B point of care test for the diagnosis of influenza in an ED
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DOI：
10.1016/j.ajem.2017.10.046
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发表时间：
2018-06-01
影响因子：
3.6
通讯作者：
Van, J. C. Nguyen
中科院分区：
文献类型：
--
作者：
Trabattoni, E.;Le, V.;Van, J. C. Nguyen
研究目的：本研究旨在评估流感流行期间在急诊科（艾德）使用Alere i Influenza A & B进行快速床旁检测（POCT）的影响。方法：在法国三级医院艾德就诊的年龄>18岁且有流感样疾病（ILI）症状的患者（N = 301）体检后，前瞻性采集直接鼻拭子2016年2月1日至3月31日期间，恰逢流感流行。2016年2月（POCT前队列）使用基于验证的检测（标准治疗）获得诊断，并使用聚合酶链反应确认阳性结果。主要终点是患者在艾德的时间。结果：共有169和132例患者分别参加了POCT前阶段和POCT阶段。POCT队列中接受阳性诊断的患者比例显著高于POCT前队列（31% vs 5.3%，P < 0.01）。POCT队列的平均艾德时间和住院率显著较低（分别为6.06 h vs 4.15 h，P = 0.03和44.4% vs 9.7%，P = 0.02）。尽管抗生素和抗病毒治疗的处方率相似，但POCT队列中转诊进行额外检查的患者比例显著较低（分别为78.1%和62.1%，P = 0.003，80.5%和63.6%，P = 0.01）。与标准治疗检测相比，Alere i Influenza A & B POCT缩短了艾德的住院时间、住院率和额外诊断检测次数。(C)2017爱思唯尔公司All rights reserved.
Study objective: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic.Methods: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18 years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N = 301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic. Laboratory-based testing (standard of care) was used to obtain a diagnosis in February 2016 (pre-POCT cohort) and positive results were confirmed using polymerase chain reaction. The primary endpoint was patient time in the ED.Results: A total of 169 and 132 patients participated in the pre-POCT phase and POCT phase respectively. A significantly higher proportion of patients received a positive diagnosis in the POCT cohort compared with the pre-POCT cohort (31% versus 5.3%, P < 0.01). Mean time spent in the ED and hospitalization rate were significantly lower in the POCT cohort (6.06 h versus 4.15 h, P = 0.03, and 44.4% versus 9.7%, P = 0.02, respectively). Despite similar rates in the prescription of antibiotics and antiviral therapies, the proportion of patients who were referred for additional tests was significantly lower in the POCT cohort (78.1% versus 62.1%, P = 0.003, and 80.5% versus 63.6%, P = 0.01, respectively).Conclusions: The Alere i Influenza A & B POCT reduced the length of stay in ED, the hospitalization rates, and the number of additional diagnostic tests compared with standard of care testing. (C) 2017 Elsevier Inc. All rights reserved.