Asymptomatic Microscopic Hematuria in Inpatient Nonsurgical Adults

Area of Science:

• Nephrology
• Urology
• Internal Medicine

Background:

• Asymptomatic microscopic hematuria (AMH) is a common finding in hospitalized patients.
• Current consensus guidelines recommend urologic investigation for AMH.

Purpose of the Study:

• To determine the proportion of nonsurgical inpatients with AMH who meet criteria for urologic investigation.

Main Methods:

• Retrospective analysis of 29,086 admissions to Israeli regional hospitals (2014-2017).
• Identified patients with 3 or more red blood cells (RBCs) per high-power field on microscopic urinalysis, excluding those with catheters or positive urine cultures.

Main Results:

• 8,389 patients underwent microscopic urinalysis.
• 2,052 patients (7.1% of total cohort) met criteria for urologic workup.
• This represents 24.4% of patients who underwent microscopic urinalysis.

Conclusions:

• A significant proportion of hospitalized nonsurgical patients with incidental AMH findings are referred for urologic workup.
• The clinical utility of such widespread referrals based on current guidelines may be questionable.