Agreement of stall-side and laboratory major crossmatch tests with the reference standard method in horses.
agglutination
alloantibody
blood incompatibility
blood type
point-of-care test
transfusion reaction
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
16
10
2019
accepted:
12
01
2020
pubmed:
6
2
2020
medline:
15
12
2020
entrez:
5
2
2020
Statut:
ppublish
Résumé
Crossmatching is used to prevent life-threatening transfusion reactions in horses. Laboratory methods are laborious and technically challenging, which is impractical during emergencies. Evaluate agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types. Twenty-four blood-typed and alloantibody-screened healthy adult horses (Aim 1) and 156 adult horses of unknown blood type (Aim 2). Prospective, blinded study. Expected positive (n = 35) and negative (n = 36) crossmatches among 24 antibody and blood-typed horses were used to determine sensitivity and specificity of KIT and LAB against the reference method. Agreement in 156 untyped horses was evaluated by reciprocal crossmatch (n = 156). Sensitivity (95% confidence interval [CI]) for LAB and KIT compared with expected reactions was 77.1% (59.9%-90.0%) and 91.4% (77.0%-98.2%), and specificity 77.8% (60.9%-89.9%) and 73.5% (55.6%-87.1%), respectively. The KIT was 100% sensitive for Aa reactions; LAB was 100% sensitive for Qab; and both were 100% sensitive for Ca. Cohen's κ agreement for LAB and KIT with expected positive and negative reactions (n = 71) was moderate (0.55 [0.36-0.74]) and substantial (0.65 [0.47-0.82]), respectively. Agreement was fair comparing LAB with KIT in Aim 1 (0.30 [0.08-0.52]) and in untyped horses in Aim 2 (0.26 [0.11-0.41]). Agreement between KIT and LAB with expected reactions was blood type dependent. Performance of both methods depends on blood type prevalence.
Sections du résumé
BACKGROUND
BACKGROUND
Crossmatching is used to prevent life-threatening transfusion reactions in horses. Laboratory methods are laborious and technically challenging, which is impractical during emergencies.
HYPOTHESIS/OBJECTIVES
OBJECTIVE
Evaluate agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types.
ANIMALS
METHODS
Twenty-four blood-typed and alloantibody-screened healthy adult horses (Aim 1) and 156 adult horses of unknown blood type (Aim 2).
METHODS
METHODS
Prospective, blinded study. Expected positive (n = 35) and negative (n = 36) crossmatches among 24 antibody and blood-typed horses were used to determine sensitivity and specificity of KIT and LAB against the reference method. Agreement in 156 untyped horses was evaluated by reciprocal crossmatch (n = 156).
RESULTS
RESULTS
Sensitivity (95% confidence interval [CI]) for LAB and KIT compared with expected reactions was 77.1% (59.9%-90.0%) and 91.4% (77.0%-98.2%), and specificity 77.8% (60.9%-89.9%) and 73.5% (55.6%-87.1%), respectively. The KIT was 100% sensitive for Aa reactions; LAB was 100% sensitive for Qab; and both were 100% sensitive for Ca. Cohen's κ agreement for LAB and KIT with expected positive and negative reactions (n = 71) was moderate (0.55 [0.36-0.74]) and substantial (0.65 [0.47-0.82]), respectively. Agreement was fair comparing LAB with KIT in Aim 1 (0.30 [0.08-0.52]) and in untyped horses in Aim 2 (0.26 [0.11-0.41]).
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Agreement between KIT and LAB with expected reactions was blood type dependent. Performance of both methods depends on blood type prevalence.
Identifiants
pubmed: 32017276
doi: 10.1111/jvim.15710
pmc: PMC7096648
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
941-948Subventions
Organisme : Harry M. Zweig Memorial Fund for Equine Research
Informations de copyright
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Références
J Vet Emerg Crit Care (San Antonio). 2016 Mar-Apr;26(2):262-8
pubmed: 26773280
Am J Vet Res. 1982 Nov;43(11):1917-21
pubmed: 7181190
MLO Med Lab Obs. 2014 Jul;46(7):34, 36
pubmed: 25158402
J Vet Intern Med. 2016 Nov;30(6):1864-1871
pubmed: 27770509
J Vet Intern Med. 2015 Nov-Dec;29(6):1683-8
pubmed: 26478135
Anim Blood Groups Biochem Genet. 1985;16(2):93-108
pubmed: 4037429
Vet Clin Pathol. 2012 Mar;41(1):56-62
pubmed: 22251607
Vet Clin Pathol. 2008 Mar;37(1):49-56
pubmed: 18366544
J Vet Emerg Crit Care (San Antonio). 2009 Feb;19(1):66-73
pubmed: 19691586
J Am Vet Med Assoc. 2007 Jul 15;231(2):267-74
pubmed: 17630896
J Vet Intern Med. 2012 May-Jun;26(3):662-7
pubmed: 22458345
J Vet Intern Med. 2020 Mar;34(2):941-948
pubmed: 32017276
J Vet Intern Med. 2019 Jul;33(4):1775-1783
pubmed: 31102487
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571