Table 3.
Comparison of 6499 patients who had any urine testing in the ED before and after intervention
| Study Cohort* |
Pre-Intervention (Sep 1st to Oct 20th) |
Post-Intervention (Oct 21st to Nov 30th) |
P-value | |
|---|---|---|---|---|
| Patient Characteristics | N=6499 | N= 3711 | N=2788 | |
| Age, median (IQR) | 46 (30–62) | 46 (29–62) | 46 (30–62) | 0.88 |
| Race, n (%) | ||||
| White | 2499 (38.5) | 1453 (39.2) | 1046 (37.5) | Ref |
| Black | 3687 (56.7) | 2086 (56.2) | 1601 (57.4) | 0.22 |
| Other | 313 (4.8) | 172 (4.6) | 141 (5.1) | 0.28 |
| Sex, n (%) | ||||
| Male | 2441 (37.6) | 1406 (37.9) | 1035 (37.1) | 0.53 |
| Female | 4058 (62.4) | 2305 (62.1) | 1753 (62.9) | Ref |
| Discharge status, n (%) | ||||
| Admitted to hospital | 2916 (44.9) | 1625 (43.8) | 1291 (46.3) | 0.55 |
| Discharged to home from ED | 3314 (51.0) | 1931 (52.0) | 1383 (49.9) | 0.84 |
| Discharged to other facility/ Expired/AMA^ | 269 (4.1) | 155 (4.2) | 114 (4.1) | Ref |
| Urine Testing Practices | ||||
| Urinalysis, n, (per 1000 ED visits) | 6556 (285.7) | 3744 (291.5) | 2812 (278.4) | 0.03 |
| Leukocyte esterase positive, n (%) | 2553 (38.9) | 1428 (38.1) | 1125 (40.0) | 0.08 |
| Urine Microscopy, n, (per 1000 ED visits) | 4408 (192.1) | 2524 (196.5) | 1813 (179.5) | 0.001 |
| Urine Microscopy Result (WBC/ hpf), n (%) | ||||
| ≤ 5 | 2540 (57.6) | 1500 (59.4) | 1040 (55.2) | Ref |
| >5 – 49 | 1209 (27.4) | 675 (26.8) | 534 (28.3) | 0.06 |
| ≥50 | 659 (15.0) | 349 (13.8) | 310 (16.5) | 0.005 |
| Urine Cultures Performed, n, (per 1000 ED visits) | 997 (43.4) | 697 (54.3) | 300 (29.7) | <.0001 |
| Positive culture, n (%) | 392 (39.3) | 270 (38.7) | 122 (40.7) | 0.43 |
| Catheterized cultures, n, (per 1000 ED visits) | 49 (2.1) | 22 (1.7) | 27 (2.7) | 0.0002 |
| Isolated culture, n (%)** | 25 (2.5) | 16 (2.3) | 9 (3.0) | 0.51 |
ED: Emergency department; IQR: Inter quartile range; AMA: Against medical advice; WBC: White blood cells; hpf: High power field
Patient visits to ED whose urine was tested (≥ 1) either for dipstick, microscopy or culture at ED during the study period. Overall 22,948 patients visited ED during Sept 1 – Nov 30 2015, 12846 during Sep 1 to Oct 20 (pre-intervention) and 10102 during Oct 21 to Nov 30 (post-intervention)
other facility- 265, Expired -4; Pre-intervention: other facility-152, expired-3; Post-intervention: other facility-113, expired-1;
Isolated is defined as a urine culture performed without either a urinalysis or urine microscopy within 24 hours before or after the culture