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Safe use of the icteric index as possible diagnostic algorithm in the determination of bilirubin

2020; Springer Science+Business Media; Volume: 16; Issue: 3 Linguagem: Inglês

10.23736/s1825-859x.20.00068-7

2039-6821

Vincenzo Roccaforte, Massimo Daves, Elvira Inglese, Vanessa Proserpio, Flavia Sciarini, Carlo Federico Perno, Stefano Pastori,

Neonatal Health and Biochemistry

BACKGROUND: The main objective of this study was to evaluate the possible role of the I-index in creating an algorithm for measuring bilirubin, assessing patient safety and possible financial savings.METHODS: We have extracted from the Laboratory Information System (LIS) all samples to which total bilirubin (TBIL) determination has been requested and icteric index (I-index) results in a 3-month period (i.e. between October 1, 2019 and December 31, 2019). The TBIL and I-index were measured on serum using the automated clinical chemistry analyzer Roche Cobas® 8000 c702 (Roche Diagnostics, Risch-Rotkreuz, Switzerland). The correlation between the TBIL and I-index was assessed with the Spearman’s rank order test and Pearson’s test. Receiver operating characteristic curve (ROC) were constructed to explore the diagnostic performance of I-index value to discriminate between normal and abnormal bilirubin values (>1.2 mg/dL; >20.5 mmol/L).RESULTS: An excellent correlation has been observed between TBIL and I-index (r=0.985). ROC curve analysis constructed to explore the diagnostic performance of I-index value for detecting TBIL values above and below 1.20 mg/dL suggested that the most accurate I-index cut-off value was >1. This cut-off showed an excellent diagnostic performance with the area under the curve of 0.975.CONCLUSIONS: The results of our retrospective analysis confirm that I-index may provide useful information on real concentration of bilirubin and show the possibility use of the index in the formulation of diagnostic algorithm in the determination of bilirubin.