Dr Fariha Imtiaz, Dr Unaiza Imtiaz, Dr Ehsan Ali
Aim: To evaluate the capability of ascitic fluid dipstick results for pH, glucose, and protein in order to predict a low serum-ascites albumin gradient (SAAG) at the bedside of the patient in the emergency department (ED). Methods: This prospective cross-sectional study was conducted for a year duration from January 2019 to January 2020 in the emergency department of the Mayo Hospital Lahore. All patients with diagnostic or therapeutic paracentesis of ascitic fluid were considered as eligible patients. Exclusion criteria included clinical suspicion of spontaneous bacterial peritonitis (PAS), any contraindication to paracentesis and patients refusing to participate in the study. Dipstick values were obtained at the patient's bedside. A low SAAG ascitic fluid was defined as the study outcome. We also used our study population as a test group to evaluate an equation proposed in one previous study: K = 0.012 Protein−0.012 Glucose−3.329 pH+23.498 Results: A total of 50 patients were enrolled in the study. Based on multivariate regression analysis, dipstick values for protein and glucose were independently predictive of a low SAAG ascitic fluid (P = 0.23, OR = 1.04; and P = 0.001, OR = 0.81, respectively). The formula proposed in one of the previous studies was tested by our data set, with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) at 84%, 83%, 84%, and 80%, respectively. Conclusion: Dipstick test for ascitic fluid pH, glucose and protein has acceptable sensitivity and specificity as a supportive point test, but cannot be recommended as an alternative to SAAG based on available results. Keywords: ascitic serum albumin gradient, ascitic fluid, rod test.