- Title
- Point-of-care derived INR does not reliably detect significant coagulopathy following Australian snakebite
- Creator
- O'Rourke, Kacey M.; Correlje, Elizabeth; Martin, Cameron L.; Robertson, Jeremy D.; Isbister, Geoffrey K.
- Relation
- Thrombosis Research Vol. 132, Issue 5, p. 610-613
- Publisher Link
- http://dx.doi.org/10.1016/j.thromres.2013.09.004
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2013
- Description
- Introduction Point-of-care international normalised ratio (INR) has been suggested as a way to screen for venom-induced consumption coagulopathy following snakebite, but has not been validated for this. This study aimed to assess the diagnostic reliability of point-of-care INR for venom-induced consumption coagulopathy. Methods This was a prospective study of snakebite patients recruited between January 2011 and May 2012 where a point-of-care INR was done and compared to an INR done on a laboratory coagulation analyser, as part of a quality assurance exercise. Data was obtained for each patient, including demographics, information on the snake bite, the point-of-care INR results and any laboratory derived coagulation studies. Snake identification was confirmed by expert identification or venom specific enzyme immunoassay. Results There were 15 patients with a median age of 29 years (2 to 68y) and 13 were male. Four of the 7 patients with venom-induced consumption coagulopathy had an abnormal point-of-care INR (3 false negatives) and 1 of the 7 non-envenomed patients had an abnormal point-of-care INR (1 false positive). The patient with a falsely elevated point-of-care INR was given antivenom prior to formal coagulation studies. The point-of-care INR was also negative in the patient with an anticoagulant coagulopathy. Conclusions The study shows that point-of-care INR testing devices should not be used in suspected snakebite cases in Australia to diagnose venom-induced consumption coagulopathy.
- Subject
- snakebite; coagulopathy; INR; point-of-care testing; envenomation; diagnostic tests
- Identifier
- http://hdl.handle.net/1959.13/1045907
- Identifier
- uon:14542
- Identifier
- ISSN:0049-3848
- Language
- eng
- Full Text
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