Cover Image

Diagnostic significance of haematological testing in patients presenting at the Emergency Department

Giuseppe Lippi, Giovanni Targher, Giampaolo Neri, Clarissa Cattabiani, Silvia Pipitone, Gianfranco Cervellin
  • Giuseppe Lippi
    U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, | lucia.zoppi@pagepress.org
  • Giovanni Targher
    Sezione di Endocrinologia e Metabolismo, Dipartimento di Medicina, Università degli Studi di Verona, Italy
  • Giampaolo Neri
    U.O. Pronto Soccorso e Medicina d’Urgenza, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliero-Universitaria di Parma, Italy
  • Clarissa Cattabiani
    U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Italy
  • Silvia Pipitone
    U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Italy
  • Gianfranco Cervellin
    U.O. Pronto Soccorso e Medicina d’Urgenza, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliero-Universitaria di Parma, Italy

Abstract

The use of simple and economic tests to rule out diseases of sufficient clinical severity is appealing in emergency department (ED), since it would be effective for contrasting ED overcrowding and decreasing healthcare costs. The aim of this study was to assess the diagnostic performance of simple and economic haematological testing in a large sample of adult patients presenting at the ED of the Academic Hospital of Parma during the year 2010 with the five most frequent acute pathologies (i.e., acute myocardial infarction, renal colic, pneumonia, trauma and pancreatitis). Both leukocyte count and hemoglobin showed a good diagnostic performance (Area Under the Curve [AUC] of 0.85 for leukocyte count and 0.76 for hemoglobin; both p < 0.01). Although the platelet count was significantly increased in all patients groups except pancreatitis, the diagnostic performance did not achieve statistical significance (AUC 0.53; p = 0.07). We also observed an increased RDW in all groups, except in those with trauma and the diagnostic performance was acceptable (AUC 0.705; p < 0.01). The mean platelet volume (MPV) was consistently lower in all patients groups and also characterized by an efficient diagnostic performance (AUC 0.76; p < 0.01). This evidence led us to design an arbitrary formula, whereby MPV and hemoglobin were multiplied, and further divided by the leukocyte count, obtaining a remarkable AUC (0.91; p < 0.01). We conclude that simple, rapid and cheap hematological tests might provide relevant clinical information for decision making to busy emergency physicians, and the their combination into an arbitrary formula might further increase the specific diagnostic potential of each of them.

Keywords

emergency department, haematological testing, lavoratory testing, rule-out test, diagnosis

Full Text:

PDF
Submitted: 2013-02-11 10:44:01
Published: 2012-03-02 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
434

Views:
PDF
352

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM




Copyright (c) 2012 Giuseppe Lippi, Giovanni Targher, Giampaolo Neri, Clarissa Cattabiani, Silvia Pipitone, Gianfranco Cervellin

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185