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INvestigating Unexplained STillbirth and Improving Care (INUSTIC) – a retrospective study at the Royal Brisbane and Women's Hospital
Author(s) -
Krystle Lander,
Ivana Goluza,
Sam Der Sarkissian,
Ian,
Wright,
Christoph Lehner,
Amanda Harry,
Anita Pelecanos,
Lauren,
Wilson,
Kate Saunders,
Renuka Sekar,
Myra Leung,
Tanya Poppe,
Anna Tottman,
Benjamin,
Thompson,
Joanna Black,
Jane Harding,
Frank,
Bloom,
eld,
Jane Alsweiler
Publication year - 2017
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13494_160
Subject(s) - medicine , retrospective cohort study , obstetrics , pediatrics , surgery
Krystle Lander, Ivana Goluza, Sam Der Sarkissian, Ian Wright NSW Health, the Wollongong Hospital, NSW, the University of Wollongong, University of Newcastle Background: Point of Care (POC) testing can be a useful clinical tool. A white cell count (wcc) differential POC device (HemoCue, Radiometer) has been shown to be accurate in older children and adults. It has not been validated in neonates, where immature cells may theoretically alter results. Methods: Routine full blood count samples from 66 admitted babies in our metropolitan neonatal nursery were immediately tested in parallel on the POC device. Mean birth gestational age was 33 weeks (range 26-39) with median sampling at 15 days (range 0–92). POC operation and laboratory results were executed masked to the other method. Comparisons used Bland–Altman (mean and SD), Spearman Rank correlation and Wilcoxon as appropriate. Results: POC and lab total wcc, neutrophils and lymphocytes were highly correlated (p < 0.0001). Mean Bland-Altman differences were small: total wcc 0.4 10/L (+/− 2SD 1.1 to −1.9), neutrophils 1.2 10/L (+/− 2SD 2.7 to −0.3), lymphocytes 0.7 10/L (+/− 2SD 1.3 to −2.7). Whilst statistically significant (p < 0.0001) these small absolute differences were clinically insignificant. Eosinophils were also significantly correlated; monocytes and basophils were not. 24% of original POC attempts resulted in error readings compared to 7% of laboratory samples being unsuitable for analysis. Conclusions: The POC device is highly correlated and in clinical agreement with laboratory values for total wcc, neutrophils and lymphocytes in this population. Consideration should be given to testing clinical utility algorithms for this methodology, as well as extending these studies to younger and sicker neonatal populations.