Accuracy and Clinical Utility of a Portable Coagulometer in an Emergency Setting
Chatchawan Rattanabannakit, MD*, Yongchai Nilanont, MD*, Chulaluk Komoltri, DrPH (Biostatistics)**, Naraporn Prayoonwiwat, MD*, Niphon Poungvarin MD, FRCP, FRI*
Affiliation : * Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Clinical Epidemiology, Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : There are limited data concerning accuracy of portable coagulometer in emergency setting.
Objective : To evaluate the accuracy of the CoaguChek® XS international normalized ratio (INR) monitor compared to the
standard laboratory method in emergency department.
Material and Method: Emergency room patients who required coagulation test were recruited. Parallel INR measurements
between portable coagulometer and standard laboratory were performed.
Results : Fifty-five patients with a mean age of 59.1 + 15.7 years (20-87) were included. Men constituted 56.4%. Indications
for testing were as follows: acute stroke 72.7%; abnormal bleeding 7.3%; taking anticoagulant 7.3%; and others 12.7%.
Mean time + SD used from blood drawn to INR result report was 65.02 + 24.5 minutes for standard laboratory and 1 minute
for portable coagulometer. Mean difference of INR result from portable coagulometer and standard laboratory was 0.02 +
0.13 and an excellence correlation between INR (r = 0.969) was demonstrated. There was no significant difference between
the INR value from the two methods (p = 0.34).
Conclusion : The use of portable coagulometer (CoaguChek® XS) in emergency setting was accurate and required less time.
Acute ischemic stroke patients are likely to benefit from a timely clinical decision making for thrombolysis medication.
Keywords : International normalized ratio (INR), Portable coagulometer, Point of care testing, Thrombolysis, Acute stroke
