Reliability of point-of-care testing of INR in acute stroke

Green, Theresa, Mansoor, Adnan, Newcommon, Nancy, Stephenson, Caroline, Stewart, Eileen, & Hill, Michael D. (2008) Reliability of point-of-care testing of INR in acute stroke. Canadian Journal of Neurological Sciences, 35(3), pp. 348-351.

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In the emergency department, portable point-of-care testing (POCT) coagulation devices may facilitate stroke patient care by providing rapid International Normalized Ratio (INR) measurement. The objective of this study was to evaluate the reliability, validity, and impact on clinical decision-making of a POCT device for INR testing in the setting of acute ischemic stroke (AIS).


A total of 150 patients (50 healthy volunteers, 51 anticoagulated patients, 49 AIS patients) were assessed in a tertiary care facility. The INR's were measured using the Roche Coaguchek S and the standard laboratory technique.


The interclass correlation coefficient and 95% confidence interval between overall POCT device and standard laboratory value INRs was high (0.932 (0.69 - 0.78). In the AIS group alone, the correlation coefficient and 95% CI was also high 0.937 (0.59 - 0.74) and diagnostic accuracy of the POCT device was 94%.


When used by a trained health professional in the emergency department to assess INR in acute ischemic stroke patients, the CoaguChek S is reliable and provides rapid results. However, as concordance with laboratory INR values decreases with higher INR values, it is recommended that with CoaguChek S INRs in the > 1.5 range, a standard laboratory measurement be used to confirm the results.

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16 citations in Web of Science®

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ID Code: 85069
Item Type: Journal Article
Refereed: Yes
Keywords: cute disease; adult; aged; anticoagulation; article; cerebrovascular accident; clinical decision making; confidence interval; controlled study; correlation coefficient; device; diagnostic accuracy; emergency ward; female; health care facility; human;, international normalized ratio; laboratory test; major clinical study; male; patient care; point of care testing; priority journal; reliability; validity; volunteer
DOI: 10.1017/S0317167100008945
ISSN: 0317-1671
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 30 Jun 2015 23:55
Last Modified: 03 Jul 2015 04:05

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