Are point of care devices effectively replacing conventional laboratory testing: Correlation of coagulation profile performed by the two methods in adult trauma patients in India

Background: Polytrauma patients frequently develop coagulopathy, which can have an adverse effect on patient outcome. Early diagnosis of coagulopathy is prudent for initiation of management, which is often not possible with central laboratory services. Point of care (POC) devices may prove useful in providing early and reliable coagulation parameters. Material and methods: Adult trauma patients, without any prior history of coagulation disorder or anticoagulant therapy, admitted to Emergency Department (ED) were recruited for the study. Blood samples were drawn from them before initiation of resuscitation, as well as after fluid resuscitation. The samples were sent to central laboratory as well as Point of Care (POC) device Abbott iSTATTM available in our ED for coagulation profile. Results: In the study population of 50 patients the correlation between lab-INR & POC-INR measurements was found to be moderately positive (Pearson’s coefficient, r = +0.66) and strongly positive (r = +0.762) after fluid resuscitation. The sensitivity, specificity, positive predictive value, and negative predictive values of the POC device were found to be 62.5%, 92.9%, 62.5%, and 92.9% respectively. The average time taken for laboratory and POC results were 3 ±1 hours & 4 ± 1 minutes respectively. Conclusion: Point of care devices provide rapid and reliable coagulation profile of a patient which can prove to be lifesaving in an emergency.