Routine urinalysis of patients in hospital in Lebanon: how worthwhile is it?
OBJECTIVE
To examine the impact of routine urinalysis at admission on inpatient care at a hospital in Lebanon, where physicians perceive it to be a valuable diagnostic tool, in a country where preventive services are underdeveloped and where the epidemiology of kidney diseases possibly differs from that of the western world.


METHODS
American University Hospital, a tertiary teaching hospital in Beirut, Lebanon.


METHODS
A retrospective medical record review of all adult patients admitted over 2 weeks to the medicine and surgery wards of the American University Hospital. Outcomes measured were frequency of routine urinalysis versus urinalysis for a clinical indication, investigation of abnormal test results, and implications of test results on clinical management.


RESULTS
367 (79%) of 462 study patients underwent urinalysis. 266 (73%) patients had routine urinalysis. Abnormal results were found in 97(37%) routine tests and 67 (66%) of those clinically indicated urinalysis (p<0.001). Abnormalities were investigated in 21 (22%) of the abnormal routine urinalyses and 45 (67%) of the abnormal clinically indicated urinalyses (p<0.001). Logistic regression analysis showed no factors to correlate positively with investigation of abnormal urinalysis. Treatment was given to two (1%) patients who had had routine urinalysis and 26 (26%) of all those tested because of a clinical indication (p<0.001).


CONCLUSIONS
Clinical response to any abnormal urinalysis is more likely when a urine test is done for a clinical indication. In this study setting, impact of routine admission urinalysis on patient care was negligible. Despite physicians' perception of routine urinalysis being a valuable case finding tool, in this study its true value remains questionable.
Pashayan
N
N
Department of Family Medicine, Faculty of Medicine, American University Of Beirut, Lebanon.
Khogali
M
M
Major
S C
SC
D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011507:Proteinuria / Q000453:epidemiology / Q000652:urine*; D012189:Retrospective Studies; D016482:Urinalysis / Q000706:statistics & numerical data*; D014570:Urologic Diseases / Q000453:epidemiology / Q000652:urine*; D014600:Utilization Review