Prevalence of interfering substances with point-of-care glucose testing in a community hospital

This study determined the prevalence of interfering substances with a glucometer using the glucose dehydrogenase pyrroloquinolinequinone method of point-of-care glucose testing (POCGT) and identified the percentage of patients with orders for an insulin product during the interference time interval.

A retrospective chart review was conducted for all inpatients with biochemically-identified interfering substances over a 12-month period. The interfering substance report identified all patients with serum uric acid concentrations greater than 10 mg/dL, hematocrit less than 20% or greater than 55%, serum total bilirubin concentrations greater than 20 mg/dL, serum acetaminophen concentrations greater than 8 mg/dL, and serum triglyceride concentrations greater than 5000 mg/dL.

Of 6885 hospital admissions during the 12-month study period, 84 patients (1.2%) were identified as having interfering substances. Interfering substances were identified an average mean +/- S.D. of 4.88 +/- 15.56 days following hospital admission. Two patients had interfering substances identified in the emergency department before hospital admission. Five patients (four with total bilirubin and one with uric acid) had initial concentrations below the interference threshold. These concentrations increased during hospitalization to high enough levels to cause interference with POCGT. Since the average length of stay for the identified patients was 10.49 days, an average of 17% of the hospital stay was impacted by an interfering substance. Substances remained at interfering concentrations until the time of discharge in 30% of the patients.

Over a 12-month period, interfering substance were identified in1.2% of patients admitted to a hospital. Thirty-six percent of those patients had an active order for an insulin product during the interference time interval.