A New Test for the Detection of Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in the Emergency Room Setting.

摘要: Determining whether a patient has taken direct oral anticoagulant (DOAC) is critical during the periprocedural and preoperative period in emergency department. However, inaccessibility of complete medical records, along with generally inconsistent sensitivity conventional coagulation tests to these drugs, complicates clinical decision making puts patients at risk uncontrollable bleeding. In this study, we evaluate utility inhibitor-II-X (i-II-X), novel, microfluidics-based diagnostic assay for detection identification Factor Xa inhibitors (FXa-Is) an acute care setting. Design First-in-human, 91-patient, single-center retrospective pilot study. Setting Emergency room. Patients Adult admitted into department, which received any clinician-ordered test requiring 3.2% buffered sodium citrate blood collection tube. Interventions None. Measurements Main Results Plasma samples from department were screened use FXa-Is, including apixaban rivaroxaban, within past 24 hours using our new i-II-X microfluidic test. results then compared tests, prothrombin time (PT) international normalized ratio (INR), ordered by treating clinicians, anti-Xa rivaroxaban. The detected DOACs collected 95.20% 100.00% specificity. Unlike PT INR, reliably identified who had prolonged clotting times secondary presence FXa-I. Conclusions overcomes limitations currently available could be useful tool routinely screen settings. Our approach particularly relevant situations where records may unavailable, or precautions need prior invasive interventions, such as specific reversal agent administration.