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Utilization of Transport Data to Decrease Unnecessarily Repeated Laboratory Tests.

Austin Brett Adair¹, Bryan Dejanovich², Michele Walsh²

¹From the Departments of Pediatric Critical Care Medicine.

Pediatric Emergency Care

|January 27, 2023

Summary

This summary is machine-generated.

Repeating laboratory tests after transporting pediatric patients with diabetic ketoacidosis is often unnecessary. Studies show transport lab values are similar to those drawn upon arrival, suggesting no added clinical value and potential cost savings.

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Area of Science:

Pediatric Emergency Medicine
Clinical Chemistry
Healthcare Economics

Background:

Pediatric patients with diabetic ketoacidosis (DKA) undergoing interfacility transport frequently have laboratory tests repeated upon arrival.
This practice may lead to redundant testing, increasing healthcare costs without significantly altering patient care trajectories.

Purpose of the Study:

To compare laboratory values (pH, sodium, potassium, chloride, bicarbonate, glucose) obtained during transport versus immediately upon arrival at the receiving institution.
To determine if repeating these tests provides additional clinical value or if transport results are sufficient.

Main Methods:

Comparative analysis of laboratory results from transport and in-house draws.
Statistical evaluation using box and whisker plots, Wilcoxon signed rank test, and paired t test.
Calculation of potential cost savings by avoiding redundant testing.

Main Results:

Box and whisker plots indicated strong similarity between transport and in-house laboratory values.
No statistically significant differences were found for chloride, pH, and potassium levels.
Statistically significant differences were observed for uncorrected sodium, corrected sodium, bicarbonate, and glucose levels.

Conclusions:

Despite some statistically significant differences, the clinical significance of repeated laboratory tests post-transport in pediatric DKA patients is questionable.
Repeating laboratory draws upon arrival does not appear to add substantial value to patient care.
Healthcare providers should consider utilizing transport laboratory values as part of the continuum of care to potentially reduce costs and improve efficiency.