Prevalence and associated factors for dipstick microscopic hematuria in men.

BACKGROUND: Microscopic hematuria is a common incidental finding on routine urinalysis. Although there are no clear recommendations to perform routine urinalysis, some studies have shown that up to 50% of general practitioners continue to perform annual routine urinalysis regardless of age or risk factors. The aim of this study was to identify associated factors and prevalence of dipstick microscopic hematuria in the general male population presenting to an annual public men's health fair. METHOD: We conducted a retrospective analysis of prospectively collected data at an annual Men's Health fair from 2008 to 2013. Patient reported health questionnaires, basic physical exam including digital rectal exam, basic bloodwork and dipstick urinalysis data was examined. RESULTS: A total of 979 patients were reviewed. Of these, 850 provided a urine sample and were included in the final analysis. Seventy-three (8.6%) patients had positive hematuria on urinalysis. Average age in both groups was 55 years. Presence of microscopic hematuria was correlated with presence of diabetes and proteinuria with odds-ratio of 2.8 (1.3-5.8) and 2.9 (1.7-5.0) respectively on multivariate analysis. There was no significant correlation identified with age, hypertension, coronary artery disease, body-mass index, smoking, prostate specific antigen (PSA) or International Prostate Symptom Score (IPSS). Limitation of this study is the lack of follow-up and knowledge of subsequent investigations of patients. CONCLUSION: Microscopic hematuria is a prevalent condition in the male population presenting to a health fair. The only factors associated with microscopic hematuria were diabetes and proteinuria. No association was found between hematuria and smoking, age, or lower urinary tract symptoms.

Reduction in allogeneic blood products with routine use of autotransfusion in open elective infrarenal abdominal aortic aneurysm repair.

BACKGROUND AND OBJECTIVES: Concern about allogeneic blood product cost and complications has prompted interest in blood conservation techniques. Intraoperative autotransfusion (IAT) is currently not used routinely by vascular surgeons in open elective infrareanl abdominal aortic aneurysm (AAA) repair. The objective of this study is to review our experience with IAT and its impact on blood transfusion. METHODS: We retrospectively reviewed the medical records of consecutive patients treated electively over a 4-year period and compared 2 strategy related to IAT, routine use IAT (rIAT) versus on-demand IAT (oIAT). Outcomes measured were number of units of allogeneic red blood cells and autologous red blood cells transfused intraoperatively and postoperatively, preoperative, postoperative, and discharge hemoglobin levels; postoperative infections; length of postoperative intensive care stay; and length of hospital stay. T-independent and Fisher exact test were used. RESULTS: A total of 212 patients were included, 38 (18%) in the rIAT and 174 (82%) in the oIAT. Groups were similar except for an inferior creatinine and a superior mean aneurysm diameter for the rIAT group. Patients in the rIAT group had a lower rate of transfusion (26% vs 54%, P = .002) and a lower mean number of blood unit transfused (0.8 vs 1.8, P = .048). These findings were still more significant for AAA larger than 60 mm (18% rIAT vs 62% oIAT, P = .0001). Postoperative hemoglobin was superior in the rIAT group (107 vs 101 g/L, P = .01). Mean postoperative intensive care length of stay was shorter for the rIAT group (1.1 vs 1.8 days, P = .01). No difference was noted for infection, mortality, or hospital length of stay. CONCLUSION: The rIAT reduced the exposure to allogeneic blood products by more than 50%, in particular for patients with AAA larger than 60 mm. These results support the use of rIAT for open elective infrarenal AAA repair.