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Usefulness of non-invasive spectrophotometric haemoglobin estimation for detecting low haemoglobin levels when compared with a standard laboratory assay for preoperative assessment

Citation

Khalafallah, AA and Chilvers, CR and Thomas, M and Chilvers, CM and Sexton, M and Vialle, M and Robertson, IK, Usefulness of non-invasive spectrophotometric haemoglobin estimation for detecting low haemoglobin levels when compared with a standard laboratory assay for preoperative assessment, British Journal of Anaesthesia, 114, (4) pp. 669-676. ISSN 1471-6771 (2015) [Refereed Article]

Copyright Statement

Copyright 2014 Crown Copyright

DOI: doi:10.1093/bja/aeu403

Abstract

BACKGROUND: Delay in diagnosis of anaemia during preoperative assessment poses logistic problems, leading to multiple clinic visits, inadequate preoperative management, and unnecessary delay of surgery. Therefore, we tested an instant spectrophotometric haemoglobin (SpHb) measurement technique to facilitate this assessment.

METHODS: We evaluated portable instant SpHb vs standard laboratory screening of anaemia between March 2012 and December 2013. Paired Hb measurements were performed on 726 patients using SpHb (Pronto-7, Masimo Corporation, Irvine, CA, USA) and Hb measured on the same day using an automated analyser. The results were obtained from a group of 638 patients from the pre-anaesthetic clinic with expected normal Hb values, and 88 patients from the oncology clinic with known low Hb.

RESULTS: Median (range) SpHb was 129.5 (67-171) compared with 136 g litre-1 (63-178) Hb measured using the automated system. Identifying Hb below a threshold of 130 g litre-1 for males had a high sensitivity (93%), while identifying a threshold of 120 g litre-1 for females had lower sensitivity (75%). The specificity for males (77%) and females (81%) was similar. Mean measurement bias and agreement: tolerability interval ratio was -8.1 g litre-1 and 2.78 for men and -3.1 g litre-1 and 2.44 for women.

CONCLUSIONS: SpHb was sensitive as a preliminary screening tool for detecting true low Hb values in males, but less sensitive in females. Instant SpHb measurement may enable prompt routine preoperative anaemia management, but its precision was lower than expected.

Item Details

Item Type:Refereed Article
Keywords:laboratory Hb, pre-anaesthetic clinic, preoperative anaemia, preoperative screening, spectrophotometric Hb
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Haematology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Blood Disorders
Author:Khalafallah, AA (Professor Alhossain Khalafallah)
Author:Robertson, IK (Dr Iain Robertson)
ID Code:99068
Year Published:2015 (online first 2014)
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-03-12
Last Modified:2017-11-03
Downloads:0

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