Miler Marijana, Nikolac Nora
University Department of Chemistry, Medical School University Hospital, Sestre Milosrdnice, Zagreb, Croatia.
Ann Clin Biochem. 2018 Jan;55(1):77-83. doi: 10.1177/0004563216687589. Epub 2017 Feb 8.
Background Microscopic examination of samples with negative dipstick results is not necessary. The aims of this study were to: (i) assess the risk of excluding urine sediment examination with negative dipstick results and (ii) calculate time savings by introducing this process. Methods The risk analysis was done for samples with negative urine dipstick and positive sediment findings. Possible missed elements in sediment were defined as 21 errors. Time saving was calculated as average time for preparation and examination sediments. Data were presented as counts and percentages. Results Out of 2997 samples, negative dipstick results were reported for 926 (30.6%) samples, out of which, microscopic examinations were positive for 527 (17.6%) samples. 18/21 errors were detected, with missing <5 squamous epithelial cells (SQEC) and bacteria 1+ as the most frequent ones (22.7% and 22.4%, respectively). Errors with the intermediate risk for patients were missing to report: ≥5 SQEC, ≥5 transitional epithelial cells, ≥10 hyaline casts (11.9%, 0.21%, 0.32%, respectively). Errors associated with high risk were not detected. Estimated total time saving is more than 25 h/month. Conclusions Microscopic examination of urine samples with negative dipstick results can be excluded without risk for patients and can result with considerable time savings.
对试条结果为阴性的样本进行显微镜检查没有必要。本研究的目的是:(i)评估排除试条结果为阴性的尿液沉渣检查的风险,以及(ii)计算引入该流程节省的时间。方法:对试条结果为阴性但沉渣检查结果为阳性的样本进行风险分析。将沉渣中可能遗漏的成分定义为21种误差。节省的时间以制备和检查沉渣的平均时间来计算。数据以计数和百分比形式呈现。结果:在2997个样本中,926个(30.6%)样本的试条结果为阴性,其中527个(17.6%)样本的显微镜检查结果为阳性。检测到18/21种误差,最常见的是遗漏<5个鳞状上皮细胞(SQEC)和1+细菌(分别为22.7%和22.4%)。对患者有中等风险的误差是漏报:≥5个SQEC、≥5个移行上皮细胞、≥10个透明管型(分别为11.9%、0.21%、0.32%)。未检测到与高风险相关的误差。估计每月总共节省时间超过25小时。结论:可以排除试条结果为阴性的尿液样本的显微镜检查,对患者没有风险,并且可以节省大量时间。