Open AccessThrombolysis in stroke patients: Comparability of point-of-care versus central laboratory international normalized ratio
Author(s) -
Ramona DolscheidPommerich,
Sarah Dolscheid,
Lars Eichhorn,
Birgit StoffelWagner,
Ingo Graeff
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0190867
Subject(s) - thrombolysis , medicine , contraindication , point of care testing , stroke (engine) , point of care , emergency medicine , myocardial infarction , pathology , mechanical engineering , engineering , alternative medicine
Background In acute stroke patients, thrombolysis is one gold standard therapy option within the first four hours after the ischemic event. A contraindication for thrombolysis is an International Normalized Ratio (INR) value >1.7. Since time is brain , rapid and reliable INR results are fundamental. Aim was to compare INR values determined by central laboratory (CL) analyzer and Point-of-Care Testing(POCT)-device and to evaluate the quality of POCT performance in cases of potential therapeutic thrombolysis at a certified stroke unit. Methods In 153 patients INR measurements using POCT-devices (HEMOCHRON Signature Elite®) were compared to INR measurements (BCS ® XP) performed at the central laboratory. Outlier evaluation was performed regarding the critical thrombolysis cut-off. Results Overall, we demonstrated a significant correlation ( r = 0.809, p <0.0001) between both measurement methods. Mean value of the absolute difference between CL-INR and POCT-INR measurements was 0.23. In 95.4% of these cases, no differences regarding the critical cut-off (INR 1.7) were observed. POCT-INR values tended to be higher than the CL-INR values ( p = 0.01). In 4.6% cases, a different value regarding thrombolysis cut-off was found. All patients were >75 years. Conclusions POCT-INR measurements based on our POCT concept are suitable to determine INR values in critical stroke patients. Nevertheless, outlier evaluation is mandatory.