Point-of-care peripheral venous blood gas in the elderly demographic in the emergency department

a pilot study

Research output: Contribution to journalArticleResearch

Abstract

Background: The peripheral venous blood gas (PVBG) has gained popularity over the arterial blood gas and electrolytes-urea-creatinine panel in non-critical situations in the emergency department (ED). Despite its convenience and rapid result return, it is costly and potentially over-utilized.Aim: To assess the utility of point of care (POC) PVBG samples in predicting re-presentation of elderly patients (over the age of 65) to the emergency department within 72 hours, who were discharged without inpatient admission directly from ED.Method: A retrospective audit was performed on patients of the above demographic, who presented to three Monash Health EDs between January 2011 and October 2015 and had a single POCPVBG sample taken. The individual POCPVBG values were compared between those who re-presented within 72 hours to those who did not, as were demographic data.Results: In the 723 eligible cases in the study period, 127 (18%) re-presented within 72 hours whilst 596 (82%) did not. The median ages were similar 76[70;82] and 77 [71;83] as was proportion of males (50%, 51%). The most common presenting complaints in both groups were shortness of breath and abdominal pain. Categorical analysis showed a statistically significant (p < 0.05) association between low base excess (OR: 2.5; 95%CI 1.2-4.9) and low potassium (OR: 2.1, 95% CI: 1.2-3.8) with re-presentation. However, these results had unclear clinical significance; the sensitivity and likelihood ratios for each were 16% and 2.2 and 15% and 1.9.Conclusion: The PVBG may have some utility as a predictor of re-presentation in non-critical presentations of elderly patients to the ED. However, the role of a single POCPVBG sample in assessment of such patients remains unclear, and further research and guidelines need to be established to avoid over-utilization
Original languageEnglish
Pages (from-to)17-22
Number of pages6
JournalMJEM: Mediterranean Journal of Emergency Medicine
Volume27
DOIs
Publication statusPublished - 2019

Cite this

@article{799505895c864c0f8c6b19996d79138e,
title = "Point-of-care peripheral venous blood gas in the elderly demographic in the emergency department: a pilot study",
abstract = "Background: The peripheral venous blood gas (PVBG) has gained popularity over the arterial blood gas and electrolytes-urea-creatinine panel in non-critical situations in the emergency department (ED). Despite its convenience and rapid result return, it is costly and potentially over-utilized.Aim: To assess the utility of point of care (POC) PVBG samples in predicting re-presentation of elderly patients (over the age of 65) to the emergency department within 72 hours, who were discharged without inpatient admission directly from ED.Method: A retrospective audit was performed on patients of the above demographic, who presented to three Monash Health EDs between January 2011 and October 2015 and had a single POCPVBG sample taken. The individual POCPVBG values were compared between those who re-presented within 72 hours to those who did not, as were demographic data.Results: In the 723 eligible cases in the study period, 127 (18{\%}) re-presented within 72 hours whilst 596 (82{\%}) did not. The median ages were similar 76[70;82] and 77 [71;83] as was proportion of males (50{\%}, 51{\%}). The most common presenting complaints in both groups were shortness of breath and abdominal pain. Categorical analysis showed a statistically significant (p < 0.05) association between low base excess (OR: 2.5; 95{\%}CI 1.2-4.9) and low potassium (OR: 2.1, 95{\%} CI: 1.2-3.8) with re-presentation. However, these results had unclear clinical significance; the sensitivity and likelihood ratios for each were 16{\%} and 2.2 and 15{\%} and 1.9.Conclusion: The PVBG may have some utility as a predictor of re-presentation in non-critical presentations of elderly patients to the ED. However, the role of a single POCPVBG sample in assessment of such patients remains unclear, and further research and guidelines need to be established to avoid over-utilization",
author = "Pourya Pouryahya and Jinghang Luo and Andis Graudins and Alastair Meyer",
year = "2019",
doi = "10.26738/MJEM.2017/MJEM27.2019/PP.OAE.270618",
language = "English",
volume = "27",
pages = "17--22",
journal = "MJEM: Mediterranean Journal of Emergency Medicine",
issn = "2222-9442",

}

TY - JOUR

T1 - Point-of-care peripheral venous blood gas in the elderly demographic in the emergency department

T2 - a pilot study

AU - Pouryahya, Pourya

AU - Luo, Jinghang

AU - Graudins, Andis

AU - Meyer, Alastair

PY - 2019

Y1 - 2019

N2 - Background: The peripheral venous blood gas (PVBG) has gained popularity over the arterial blood gas and electrolytes-urea-creatinine panel in non-critical situations in the emergency department (ED). Despite its convenience and rapid result return, it is costly and potentially over-utilized.Aim: To assess the utility of point of care (POC) PVBG samples in predicting re-presentation of elderly patients (over the age of 65) to the emergency department within 72 hours, who were discharged without inpatient admission directly from ED.Method: A retrospective audit was performed on patients of the above demographic, who presented to three Monash Health EDs between January 2011 and October 2015 and had a single POCPVBG sample taken. The individual POCPVBG values were compared between those who re-presented within 72 hours to those who did not, as were demographic data.Results: In the 723 eligible cases in the study period, 127 (18%) re-presented within 72 hours whilst 596 (82%) did not. The median ages were similar 76[70;82] and 77 [71;83] as was proportion of males (50%, 51%). The most common presenting complaints in both groups were shortness of breath and abdominal pain. Categorical analysis showed a statistically significant (p < 0.05) association between low base excess (OR: 2.5; 95%CI 1.2-4.9) and low potassium (OR: 2.1, 95% CI: 1.2-3.8) with re-presentation. However, these results had unclear clinical significance; the sensitivity and likelihood ratios for each were 16% and 2.2 and 15% and 1.9.Conclusion: The PVBG may have some utility as a predictor of re-presentation in non-critical presentations of elderly patients to the ED. However, the role of a single POCPVBG sample in assessment of such patients remains unclear, and further research and guidelines need to be established to avoid over-utilization

AB - Background: The peripheral venous blood gas (PVBG) has gained popularity over the arterial blood gas and electrolytes-urea-creatinine panel in non-critical situations in the emergency department (ED). Despite its convenience and rapid result return, it is costly and potentially over-utilized.Aim: To assess the utility of point of care (POC) PVBG samples in predicting re-presentation of elderly patients (over the age of 65) to the emergency department within 72 hours, who were discharged without inpatient admission directly from ED.Method: A retrospective audit was performed on patients of the above demographic, who presented to three Monash Health EDs between January 2011 and October 2015 and had a single POCPVBG sample taken. The individual POCPVBG values were compared between those who re-presented within 72 hours to those who did not, as were demographic data.Results: In the 723 eligible cases in the study period, 127 (18%) re-presented within 72 hours whilst 596 (82%) did not. The median ages were similar 76[70;82] and 77 [71;83] as was proportion of males (50%, 51%). The most common presenting complaints in both groups were shortness of breath and abdominal pain. Categorical analysis showed a statistically significant (p < 0.05) association between low base excess (OR: 2.5; 95%CI 1.2-4.9) and low potassium (OR: 2.1, 95% CI: 1.2-3.8) with re-presentation. However, these results had unclear clinical significance; the sensitivity and likelihood ratios for each were 16% and 2.2 and 15% and 1.9.Conclusion: The PVBG may have some utility as a predictor of re-presentation in non-critical presentations of elderly patients to the ED. However, the role of a single POCPVBG sample in assessment of such patients remains unclear, and further research and guidelines need to be established to avoid over-utilization

U2 - 10.26738/MJEM.2017/MJEM27.2019/PP.OAE.270618

DO - 10.26738/MJEM.2017/MJEM27.2019/PP.OAE.270618

M3 - Article

VL - 27

SP - 17

EP - 22

JO - MJEM: Mediterranean Journal of Emergency Medicine

JF - MJEM: Mediterranean Journal of Emergency Medicine

SN - 2222-9442

ER -