BACKGROUND: Early detection of underlying renal dysfunction among emergency patients is important, particularly before imaging studies using contrast media. The estimated glomerular filtration rate (eGFR) calculated from creatinine values is useful in situations requiring rapid evaluation and detection of renal impairment. METHODS: We evaluated the concordance of eGFR determined using the whole blood creatinine test by Nova CCX (Cr-CCX WB; Nova Biomedical, USA) method and the serum creatinine test by Roche Integra 800 (Cr-RE Serum; Roche Diagnostics, Switzerland) enzymatic method, which is known to be traceable to the isotope dilution mass spectrometric (ID-MS) reference method. RESULTS: Compared to Cr-RE Serum (x), Cr-CCX WB (y) showed good correlation but unacceptable total error and negative proportional bias (Deming regression, y=0.92x+0.02; r=0.98; n=61). However, when we adjusted the Cr-CCX WB values with a new slope and offset derived from the Deming regression analysis with Cr-RE Serum, the concordance rate improved from 0.77 to 0.93 (as measured by kappa statistics), and total errors became acceptable except at 1 level. When we used the ID-MS traceable eGFR formula, the Nova CCX demonstrated sufficient sensitivity (93.5%) and specificity (100%) for the detection of renal dysfunction (eGFR less than 60 mL/min/1.73 m2) in patients. CONCLUSIONS: We concluded that if we adjusted the harmonizing factors of Nova CCX according to the ID-MS traceable method, then the Nova CCX might be a relatively accurate point-of-care creatinine analyzer for detecting renal dysfunction among patients undergoing urgent imaging studies with radiological contrast media.
Bias (Epidemiology) ; Contrast Media ; Creatinine ; Emergencies ; Glomerular Filtration Rate ; Humans ; Sensitivity and Specificity

PURPOSE: We determine the Korean antibody titer and positive rate of tetanus by using a with qualitative test (ELISA) and a quantitative test (TQS(R)). METHODS: This study was prospective collecting study with uncontolled patients who were admitted in 21 Emergency Departments during 3 months in South Korea. We measured TQS(R) and collected the serum with a centrifuge for 5 groups, which was classified with age: 2~10 years (I), 11~20 years (II), 21~30 years (III), 31~40 years (IV), 41~60 years (V), in each hospital. The freezed serum and the protocol with TQS(R) results were taken at the Soonchunhyang University Bucheon hospital to be analyzed. RESULTS: The number of enrolled patients was 1816 (male 58%). The positive rate of TQS(R) was 835 patients (46%), and there was no relation with region or sex. In sex and age, there was a definitive decline in the group III fort males and females. The results of ELISA was showed that 62.8% (> 0.15 IU/ml) and 52.2% (> 0.2 IU/ml) had protective levels of tetanus antibody. The proportion decreased to approximately 43% and 18% among persons 40~60 years of age at each level of antibody titers. By region and population, there was no statistical relationship with TQS(R) and ELISA, but previous military service was associated with a higher prevalence of protective antibodies to tetanus (p<0.001). CONCLUSIONS: A substantial portion of adults in South Korea do not have antibody levels that are protective against tetanus. Also, the mean level of tetanus antibody titers was definitively lower than those of other developed conturies and consistently decreased with aging. Therefore, an adult formulation diphteria and tetanus toxoid every 5 or 10 years is recommended for all adults between 20 and 60 years of age after being tested with TQS(R) in South Korea.
Adult ; Aging ; Antibodies ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Epidemiology ; Female ; Gyeonggi-do ; Humans ; Korea ; Male ; Military Personnel ; Prevalence ; Prospective Studies ; Tetanus ; Tetanus Toxoid