Evaluation of a New Point-of-care Diagnostic Test Measuring Inflammation in Emergency Settings

Overview

Journal Sci Rep

Specialty Science

Date 2023 Nov 9

PMID 37945629

Authors

Olivier L Charansonney

Ghanima Al-Dandachi

Patrick Plaisance

Eric Vicaut

Affiliations

Soon will be listed here.

Abstract

Erythrocyte aggregation kinetics is accelerated in diseases with a strong inflammation component. This study aimed to evaluate whether, in an emergency setting, a new point-of-care test measuring erythrocyte aggregation kinetics (EAK) can identify patients with underlying inflammation. Patients visiting an emergency department and needing a blood exam were successively included. EAK was measured at the point-of-care in 20 s directly on the blood samples collected in regular tubes without any manipulation. The primary measure was EAK's half-life during the first 5 s (EAK5s). Each patient's inflammation status was assessed blind to the EAK test results. Receiver Operating Characteristic (ROC) curves for inflammation status were built. 268 patients had their EAK5s measured, and a clear inflammation status was determined for 214 patients (65 had inflammation). Mean EAK5s were 2.18 s and 1.75 s for no inflammation and inflammation groups respectively (p < 0.001). EAK5s appears to be a better inflammation marker than C-Reactive protein (CRP), with an area under the ROC curve of 0.845 compared to 0.806 for CRP (p < 0.0001). The Youden threshold for prediction of inflammation was 1.86 s with 84.6% (78.5-89.9%) specificity and 70.8% (60-81.5%) sensitivity. Point-of-care EAK is an easily measured, immediately available marker of inflammation with a better predictive power than CRP's.

References

Perkkio J, Wurzinger L, Schmid-Schonbein H . Fåhraeus-Vejlens effect: margination of platelets and leukocytes in blood flow through branches. Thromb Res. 1988; 50(3):357-64. DOI: 10.1016/0049-3848(88)90265-4. View

Pohanka M . Diagnoses Based on C-Reactive Protein Point-of-Care Tests. Biosensors (Basel). 2022; 12(5). PMC: 9138282. DOI: 10.3390/bios12050344. View

Umemneku Chikere C, Wilson K, Graziadio S, Vale L, Allen A . Diagnostic test evaluation methodology: A systematic review of methods employed to evaluate diagnostic tests in the absence of gold standard - An update. PLoS One. 2019; 14(10):e0223832. PMC: 6788703. DOI: 10.1371/journal.pone.0223832. View

Gyawali P, Ziegler D, Cailhier J, Denault A, Cloutier G . Quantitative Measurement of Erythrocyte Aggregation as a Systemic Inflammatory Marker by Ultrasound Imaging: A Systematic Review. Ultrasound Med Biol. 2018; 44(7):1303-1317. DOI: 10.1016/j.ultrasmedbio.2018.02.020. View

Semenov A, Lugovtsov A, Shirshin E, Yakimov B, Ermolinskiy P, Bikmulina P . Assessment of Fibrinogen Macromolecules Interaction with Red Blood Cells Membrane by Means of Laser Aggregometry, Flow Cytometry, and Optical Tweezers Combined with Microfluidics. Biomolecules. 2020; 10(10). PMC: 7602533. DOI: 10.3390/biom10101448. View

Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez J . pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics. 2011; 12:77. PMC: 3068975. DOI: 10.1186/1471-2105-12-77. View

Nash G, Watts T, Thornton C, Barigou M . Red cell aggregation as a factor influencing margination and adhesion of leukocytes and platelets. Clin Hemorheol Microcirc. 2008; 39(1-4):303-10. View

Hajian-Tilaki K . Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation. Caspian J Intern Med. 2013; 4(2):627-35. PMC: 3755824. View

Deng Y, Papageorgiou D, Li X, Perakakis N, Mantzoros C, Dao M . Quantifying Fibrinogen-Dependent Aggregation of Red Blood Cells in Type 2 Diabetes Mellitus. Biophys J. 2020; 119(5):900-912. PMC: 7474208. DOI: 10.1016/j.bpj.2020.07.026. View

10.

Dominguez J, Xie D, Kelly K . Impaired microvascular circulation in distant organs following renal ischemia. PLoS One. 2023; 18(6):e0286543. PMC: 10237479. DOI: 10.1371/journal.pone.0286543. View

11.

Zhang Z, Meiselman H, Neu B . Red blood cell adhesion can be reduced by non-reactive macromolecules. Colloids Surf B Biointerfaces. 2018; 174:168-173. DOI: 10.1016/j.colsurfb.2018.11.015. View

12.

Dixon S, Fanshawe T, Mwandigha L, Edwards G, Turner P, Glogowska M . The Impact of Point-of-Care Blood C-Reactive Protein Testing on Prescribing Antibiotics in Out-of-Hours Primary Care: A Mixed Methods Evaluation. Antibiotics (Basel). 2022; 11(8). PMC: 9332095. DOI: 10.3390/antibiotics11081008. View

13.

Kunakornsawat S, Tungsiripat R, Putthiwara D, Piyakulkaew C, Pluemvitayaporn T, Pruttikul P . Postoperative Kinetics of C-Reactive Protein and Erythrocyte Sediment Rate in One-, Two-, and Multilevel Posterior Spinal Decompressions and Instrumentations. Global Spine J. 2017; 7(5):448-451. PMC: 5544159. DOI: 10.1177/2192568217699389. View

14.

Charansonney O, Morel P, Dufaux J, Vicaut E . Description and validation of a new, simple, easy-to handle, point-of-care technique for measuring erythrocyte aggregation kinetics. Sci Rep. 2022; 12(1):14798. PMC: 9427804. DOI: 10.1038/s41598-022-18410-6. View

15.

Salazar J, Martinez M, Chavez-Castillo M, Nunez V, Anez R, Torres Y . C-Reactive Protein: An In-Depth Look into Structure, Function, and Regulation. Int Sch Res Notices. 2016; 2014:653045. PMC: 4897210. DOI: 10.1155/2014/653045. View

16.

Ong P, Namgung B, Johnson P, Kim S . Effect of erythrocyte aggregation and flow rate on cell-free layer formation in arterioles. Am J Physiol Heart Circ Physiol. 2010; 298(6):H1870-8. PMC: 2886628. DOI: 10.1152/ajpheart.01182.2009. View

17.

Charansonney O, Mouren S, DUFAUX J, DUVELLEROY M, Vicaut E . Red blood cell aggregation and blood viscosity in an isolated heart preparation. Biorheology. 1993; 30(1):75-84. View

18.

Baskurt O, Meiselman H . Erythrocyte aggregation: basic aspects and clinical importance. Clin Hemorheol Microcirc. 2012; 53(1-2):23-37. DOI: 10.3233/CH-2012-1573. View