The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients

Nasir Wabe*, Ling Li, Robert Lindeman, Ruth Yimsung, Maria R. Dahm, Kate Clezy, Susan McLennan, Johanna Westbrook, Andrew Georgiou

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To determine whether rapid polymerase chain reaction (PCR) testing for influenza and respiratory syncytial viruses (RSV) in emergency departments (EDs) is associated with better patient and laboratory outcomes than standard multiplex PCR testing. Design, setting: A before-and-after study in four metropolitan EDs in New South Wales. Participants: 1491 consecutive patients tested by standard multiplex PCR during July–December 2016, and 2250 tested by rapid PCR during July–December 2017. Main outcome measures: Hospital admissions; ED length of stay (LOS); test turnaround time; patient receiving test result before leaving the ED; ordering of other laboratory tests. Results: Compared with those tested by standard PCR, fewer patients tested by rapid PCR were admitted to hospital (73.3% v 77.7%; P < 0.001) and more received their test results before leaving the ED (67.4% v 1.3%; P < 0.001); the median test turnaround time was also shorter (2.4 h [IQR, 1.6–3.9 h] v 26.7 h [IQR, 21.2–37.8 h]). The proportion of patients admitted to hospital was also lower in the rapid PCR group for both children under 18 (50.6% v 66.6%; P < 0.001) and patients over 60 years of age (84.3% v 91.8%; P < 0.001). Significantly fewer blood culture, blood gas, sputum culture, and respiratory bacterial and viral serology tests were ordered for patients tested by rapid PCR. ED LOS was similar for the rapid (7.4 h; IQR, 5.0–12.9 h) and standard PCR groups (6.5 h; IQR, 4.2–11.9 h; P = 0.27). Conclusion: Rapid PCR testing of ED patients for influenza virus and RSV was associated with better outcomes on a range of indicators, suggesting benefits for patients and the health care system. A formal cost–benefit analysis should be undertaken.

Original languageEnglish
Pages (from-to)316-320
Number of pages5
JournalMedical Journal of Australia
Volume210
Issue number7
Early online date5 Mar 2019
DOIs
Publication statusPublished - 1 Apr 2019

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Diagnostic tests and procedures
  • Emergency services, medical
  • Public health

Fingerprint Dive into the research topics of 'The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients'. Together they form a unique fingerprint.

  • Cite this