How much is blood cultures valuable for adult emergency department patients?

Abstract

Introduction: Infection diseases are among the most common cases evaluated in every emergency department. The use of blood cultures is considered to be a golden standard test for the evaluation of such diseases. The purpose of this study is to investigate the effect of blood cultures taken in the emergency department on the clinical decisions and cost efficiency.
Material and Method: This retrospective study was conducted between April 2004 and June 2005 at the Emergency Department of Afyon Kocatepe University Medical School. Data were obtained from medical files. Demographic properties, onset time of symptoms, blood culture results, final diagnoses and cost efficiency of blood cultures were analyzed.
Results: 103 patients were included to the study. Patients were male in 54.4% and their average age was 45.6±19.5 (median). A total of 189 blood cultures were taken from 103 patients. Of the blood cultures taken from 17 of the patients (16.5%) were aerobic only. Blood cultures taken from 86 patients (83.5%) were both aerobic and anaerobic. The results of 6 patients (5.8%) were positive in both aerobic and anaerobic blood cultures, but only 3 patients (2.9%) in aerobic blood cultures. Positive blood cultures from 2 patients (1.6%) were discarded from the study because of possibble contamination. The microorganisms in the positive blood cultures were found not to be anaerobic agents. Blood cultures were positive in 3 of the patients (7%) discharged from emergency department. However, this did not make any change on the management of the patients.
Conclusion: Blood cultures are still frequently used to investigate infection diseases in the emergency departments but this does not change the management procedures of the patients followed as outpatient. The results imply that it would be beneficial both for clinical improvements and cost efficiency if emergency department physicians are more selective in receiving blood cultures.