clinicaltrials.gov Identifier: NCT01822795.

Our results indicate that gold-standard monitoring for patients with cirrhosis is cost-effective, attributed to a higher probability of benefiting from a curative treatment and so a higher survival probability. (Hepatology 2017;65:1237-1248).

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No abstract

Objectives: Crowding is a frequent concern in the emergency department (ED). Laboratory point-of-care testing (POCT) has been proposed to decrease patients' length of stay (LOS). Our objective was to determine whether an extended panel of POCT solutions could reduce LOS. Methods: This was a single-center, prospective, open-label, controlled cluster-randomized study. Blood test processing was randomized into 1-week inclusion periods: interventional arm (laboratory analyses performed on POCT analyzers implemented in the ED) or control arm (central laboratory). The primary endpoint was LOS of patients in the ED. Secondary endpoints were time to result (TTR), ED crowding surrogates, and average total cost of an ED visit in each arm. Results: A total of 23,231 patients were included and 20,923 were analyzed for the main outcome measure. Mean AE SD age was 46 AE 20 years, and 7,905 (36%) underwent blood sampling. Mean AE SD LOSs were 203 AE 161 and 210 AE 168 minutes in the POCT and control arms, respectively. LOS reduction for the entire ED population was À9 minutes (95% confidence interval [CI] = À22 to 5, p = 0.22) compared to the control arm and À17 minutes (95% CI = À34.0 to 0.6, p = 0.06) for patients undergoing blood sampling. The mean AE SD TTRs were 28 AE 31 and 79 AE 34 minutes in the POCT and control arms, respectively (TTR reduction = À51 minutes, 95% CI = À54 to À48 minutes, p < 0.001).