• Kamran Heidari, Mohammad Amiri, Hamid Kariman, Maryam Bassiri, Hossein Alimohammadi, and Hamidreza Reza Hatamabadi.
• Emergency Medicine Department, Haftom Tir Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
• Am J Emerg Med. 2013 May 1;31(5):779-82.

AbstractThe aim of present study was to determine the reliability of the dipstick values (protein, glucose, and pH) for differentiation of exudate from transudate ascites in comparison with the serum-ascites albumin gradient as criterion standard. A total of 100 patients with ascites (58 males and 42 females; mean age, 55.6 ± 16.1 years) were studied for the different causes of ascites. Peripheral blood samples were obtained, and at the same time, the patients underwent paracentesis. There were 62 cases (62.0%) of transudate ascites and 38 (38.0%) of exudates ascites, based on serum-ascites albumin gradient. Using logistic regression, we found a dipstick equation (K = 0.012Protein - 0.012Glucose - 3.329pH + 23.498) to differentiate transudate (K < 0) from exudate (K > 0) ascites. The sensitivity, specificity, positive predictive value, and negative predictive value of dipstick equation to diagnose ascites as transudate and exudate were 93.8%, 94.4%, 96.8%, and 89.5%, respectively, and 94.4%, 93.9%, 89.5%, and 96.9%, respectively. The area under the receiver operating characteristic curve was 0.915 (95% confidence interval, 0.848-0.982; P < .001). We concluded that the dipstick can be an inexpensive, rapid, and simple option for categorizing ascites into transudate and exudate and can be used routinely for this purpose in clinical practice.Copyright © 2013 Elsevier Inc. All rights reserved.

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