Cost effectiveness and Clinical outcomes of B-type Natriuretic Peptide (BNP) Point of Care Testing versus BNP Laboratory testing for Adults with Dyspnoea in the Department of Emergency Medicine at Nambour General Hospital.

Evaluate how using BNP point-of-care testing in the Department of Emergency Medicine at Nambour General Hospital for adult patients presenting with acute dyspnoea impacts on patient outcomes, clinical significance, cost effectiveness and DEM patient flow when compared with laboratory testing.

Grant ID: EMT-2008-005-WARD-BNP

Project Summary

Patient flow and access block will be evaluated through comparing time to decision making in the Emergency Department (ED) and Emergency Department length of stay (ED LOS) between patients who have POC and Laboratory BNP testing. Cost effectiveness will be evaluated by reviewing treatment type given, admission rate, ICU admission rate, inpatient length of stay (IP LOS), Emergency Department Length of Stay and 30day readmission rate.

This study will build upon the findings of a similar concurrent study. Both studies demonstrate a poor utility in BNP testing in patients presenting with shortness of breath in reducing Emergency Department length of stay. While this limits the potential for BNP Point of care testing within the ED, the validated Abbott Point of Care BNP cartridge will have the good potential for improving patient care in rural and remote cardiac outpatient locations where current BNP testing results take several days to obtain.

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Outcomes

One-hundred fifty consecutive adult patients presenting with acute dyspnea to Nambour Hospital Emergency Department were recruited. B-type natriuretic peptide levels were compared (using the Abbott POC analyzer and the laboratory), as were grouped levels using clinically useful accepted reference ranges (<100, 100-500, and >500 pg/mL). The data were tested using general correlation and least squares regression.

The correlation between the POC and laboratory BNP results was strong, R2 = 0.87. There is a good correlation for the measurement of BNP between Abbott POC BNP and laboratory BNP analyzer. The Abbott (Chicago, Ill) POC BNP analyzer is suitable for measurement of BNP in Australian emergency departments.

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Dissemination

Stuckey, L., Ward, D. and Negus, P., 2011. Correlation Between Point-of-Care and Laboratory-Analyzed B-Type Natriuretic Peptide in Adult Patients Presenting to Nambour Hospital Emergency Department With Shortness of Breath. Point of Care, 10(1), pp.25-27.

Conference Presentation:
Stuckey L, Ward D, Negus P, Anstey C. Correlation between Point of Care and Laboratory analysed B-type Natriuetic Peptide in adult patients presenting to Nambour Hospital Emergency Department with shortness of breath. 2009 6th Annual QLD Autumn Symposium, Australasian College For Emergency Medicine, Gold Coast April 2009.

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