Publicerat



Scandinavian Journal of Urology and Nephrology, 2006; 40: 149 - 154



ORIGINAL ARTICLE



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



Abstract

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



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