Clinical and operational impact of rapid point-of-care SARS-CoV-2 detection in an emergency department.

Autor: Gerlier C; Service des Urgences, Groupe Hospitalier Paris Saint-Joseph, Paris, France., Pilmis B; Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Institut Micalis, UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Châtenay-Malabry, France., Ganansia O; Service des Urgences, Groupe Hospitalier Paris Saint-Joseph, Paris, France., Le Monnier A; Institut Micalis, UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Châtenay-Malabry, France; Service de Microbiologie Clinique et Plateforme de Dosage des Anti-infectieux, Groupe Hospitalier, Paris, France., Nguyen Van JC; Service de Microbiologie Clinique et Plateforme de Dosage des Anti-infectieux, Groupe Hospitalier, Paris, France. Electronic address: jcnguyen@ghpsj.fr.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2021 Dec; Vol. 50, pp. 713-718. Date of Electronic Publication: 2021 Sep 28.
DOI: 10.1016/j.ajem.2021.09.062
Abstrakt: Study Objective: Rapid point-of-care (POC) SARS-CoV-2 detection with Abbott ID NOW™ COVID-19 test has been implemented in our Emergency Department (ED) for several months. We aimed to evaluate the operational impact and potential benefits of this innovative clinical pathway.
Methods: We conducted a prospective, descriptive, interventional, non-randomized study, before-after trial with the comparison of patient cohorts from two consecutive periods of seven weeks (observational pre-POC period vs interventional POC period).
Results: In 2020, throughout weeks 37 to 50, 3333 patients were assessed for eligibility and among them 331 (9.9%) were positive for SARS-CoV-2 infections. Among the included patients, 136 (9.2%) were positive for SARS-CoV-2 infection in the pre-POC period and 195 (10.5%) in the POC period. Among positive patients for SARS-CoV-2 related infection in-hospital mortality rate was similar between the two groups but the hospitalization rate was higher in the POC group (81.6% vs. 65.4%; p < 0.001). More patients in the POC period were able to leave the ED within 6 h. We examined rates of antibiotic, anticoagulant, and corticosteroid prescriptions among patients tested for SARS-CoV-2 in the ED. Only the rate of prescribed anticoagulants was found to be higher in the POC period (40% vs. 24.2%; p < 0.003).
Conclusion: We demonstrated that COVID-19 point-of-care testing speeds up clinical decision-making, improving use of recommended treatments for COVID-19, such as anticoagulants. Moreover, it improves the boarding time and significantly shortened the length of stay in the ED for patients requiring outpatient care.
Competing Interests: Declaration of Competing Interest This work presented was not funded. None of the authors declare any personal or financial conflict of interest in relation to this manuscript.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: