Impact of a rapid respiratory panel test on patient outcomes

Beverly B. Rogers, Prabhu Rv Shankar, Robert C. Jerris, David Kotzbauer, Evan J. Anderson, J. Renee Watson, Lauren A. O'Brien, Francine Uwindatwa, Kelly McNamara, James E. Bost

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Context. - Evolution of polymerase chain reaction testing for infectious pathogens has occurred concurrent with a focus on value-based medicine. Objective. - To determine if implementation of the FilmArray rapid respiratory panel (BioFire Diagnostics, Salt Lake City, Utah) (hereafter RRP), with a shorter time to the test result and expanded panel, results in different outcomes for children admitted to the hospital with an acute respiratory tract illness. Design. - Patient outcomes were compared before implementation of the RRP (November 1, 2011, to January 31, 2012) versus after implementation of the RRP (November 1, 2012, to January 31, 2013). The study included inpatients 3 months or older with an acute respiratory tract illness, most admitted through the emergency department. Testing before RRP implementation used batched polymerase chain reaction analysis for respiratory syncytial virus and influenza A and B, with additional testing for parainfluenza 1 through 3 in approximately 11% of patients and for human metapneumovirus in less than 1% of patients. The RRP tested for respiratory syncytial virus, influenza A and B, parainfluenza 1 through 4, human metapneumovirus, adenovirus, rhinovirus/enterovirus, and coronavirus NL62. Results. - The pre-RRP group had 365 patients, and the post-RRP group had 771 patients. After RRP implementation, the mean time to the test result was shorter (383 minutes versus 1119 minutes, P < .001), and the percentage of patients with a result in the emergency department was greater (51.6% versus 13.4%, P < .001). There was no difference in whether antibiotics were prescribed, but the duration of antibiotic use was shorter after RRP implementation (P = .003) and was dependent on receiving test results within 4 hours. If the test result was positive, the inpatient length of stay (P = .03) and the time in isolation (P = .03) were decreased after RRP implementation compared with before RRP implementation. Conclusions. - The RRP decreases the duration of antibiotic use, the length of inpatient stay, and the time in isolation.

Original languageEnglish (US)
Pages (from-to)636-641
Number of pages6
JournalArchives of Pathology and Laboratory Medicine
Volume139
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Metapneumovirus
Paramyxoviridae Infections
Inpatients
Respiratory Syncytial Viruses
Anti-Bacterial Agents
Respiratory System
Human Influenza
Hospital Emergency Service
Length of Stay
Human Adenoviruses
Rhinovirus
Polymerase Chain Reaction
Coronavirus
Enterovirus
Medicine

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology
  • Medicine(all)

Cite this

Rogers, B. B., Shankar, P. R., Jerris, R. C., Kotzbauer, D., Anderson, E. J., Watson, J. R., ... Bost, J. E. (2015). Impact of a rapid respiratory panel test on patient outcomes. Archives of Pathology and Laboratory Medicine, 139(5), 636-641. https://doi.org/10.5858/arpa.2014-0257-OA

Impact of a rapid respiratory panel test on patient outcomes. / Rogers, Beverly B.; Shankar, Prabhu Rv; Jerris, Robert C.; Kotzbauer, David; Anderson, Evan J.; Watson, J. Renee; O'Brien, Lauren A.; Uwindatwa, Francine; McNamara, Kelly; Bost, James E.

In: Archives of Pathology and Laboratory Medicine, Vol. 139, No. 5, 01.05.2015, p. 636-641.

Research output: Contribution to journalArticle

Rogers, BB, Shankar, PR, Jerris, RC, Kotzbauer, D, Anderson, EJ, Watson, JR, O'Brien, LA, Uwindatwa, F, McNamara, K & Bost, JE 2015, 'Impact of a rapid respiratory panel test on patient outcomes', Archives of Pathology and Laboratory Medicine, vol. 139, no. 5, pp. 636-641. https://doi.org/10.5858/arpa.2014-0257-OA
Rogers, Beverly B. ; Shankar, Prabhu Rv ; Jerris, Robert C. ; Kotzbauer, David ; Anderson, Evan J. ; Watson, J. Renee ; O'Brien, Lauren A. ; Uwindatwa, Francine ; McNamara, Kelly ; Bost, James E. / Impact of a rapid respiratory panel test on patient outcomes. In: Archives of Pathology and Laboratory Medicine. 2015 ; Vol. 139, No. 5. pp. 636-641.
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