Scandinavian Journal of Urology and Nephrology, 2006; 40: 149 - 154
A simple device (Hemostick ®) for the standardized description of macroscopic
haematuria: Our initial experience.
NINA HAGEMAN1, TRINE ARONSEN1 & HANS-GÖRAN TISELIUS1,2
1Department of Urology, Karolinska University Hospital, Stockholm, Sweden, and 2the Division of Urology, Department of Clinical Science,
Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
Objective. To evaluate the clinical use of a simple device (Hemostick) developed to enable a standardized description of the degree of macroscopic haematuria. Material and methods. The visual scale (Hemostick) used in this study comprised six colour fields, one yellow (blank; 0) and five with different nuances of red (1 - 5) selected from a colour scale according to clinical observations of samples obtained from patients with macroscopic haematuria. Urine samples containing blood were examined and given a Hemostick score (HS) of 0 - 5, based on comparison with the colour fields on the scale. In three experimental series, (A) 63, (B+C) 14 and (D) 60 x4 urine samples were examined by observers. The reported HS was compared with the personal descriptions of the degree of haematuria. We also assessed the absorbance at 412 nm, the haemoglobin concentration and the number of erythrocytes. Results. In the first two series (A and B+C) comprising 325 observations on 77 urine samples, the HS for the same sample as reported by the observers was in agreement in 75 - 93% of cases. In Series B+C the coefficient of variation was 0.06 and the mode 2.68, which was almost identical to the observed mean HS value of 2.69. Based on observations on 240 urine samples considered by four observers during four consecutive days (Series D), an acceptable agreement was recorded in 74 - 94% of cases. In this experiment the mean HS differed from the mode by not more than 0.12 - 0.19. In terms of absorbance there was very good discrimination between samples with HSs 1, 2, 3 and 4. Measurements of the haemoglobin concentration (g/l) gave us the following approximate ranges for HSs 0, 1, 2, 3 and 4: B0.2, 0.2 - 1, 1 - 5, 5 - 25 and >25, respectively. Samples with HS 5 comprised those with a high concentration of old blood. Conclusions. The results of this series of experiments involving scoring of macroscopic haematuria were encouraging. The Hemostick device was easy to use and resulted in a satisfactory consensus regarding the degree of haematuria and one that was superior to that deduced from a personal terminology.
Key Words: Blood loss, documentation, macroscopic haematuria, patient care, recording, standardized description, urine