Abstract

Background: Excessive ascitic fluid accumulation in the peritoneal cavity is seen as a clinical problem in all parts of the world by many doctors. This study attempts to differentiate exudate and transudate ascitic fluid by use of point of care dipstick.
Methodology: A total of 67 patients with ascites were recruited from Lagos University Teaching Hospital, Nigeria, for this study. Using serum ascites albumin gradient (SAAG) as standard way of classifying ascitic fluid into exudate and transudate by using the assessment of dipstick protein. SAAG was calculated based on albumin values of venous blood and ascitic fluid. SAAG less than 11 g/l represented exudate while SAAG greater than 11 g/l represented transudate. Values obtained were classified as high protein dipstick and low protein dipstick.
Results: The age range was 18–65 years with mean age of 47.11 ± 11.21 for both genders. Mean body mass index was 24.19 ± 2.9. A total of 41 (61.2%) had high ascitic fluid protein based on dipstick (500 mg/dl), while 26 had low ascitic fluid protein (30 mg/dl). SAAG was the standard used to differentiate exudates from transudate. In comparing dipstick protein (high or low) to correlate with low SAAG (exudates) and high SAAG (transudate) yielded a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 63.4%, 42.3%, 63.4%, 42.3%, and 70.3%, respectively.
Conclusion: SAAG is a better indicator of classifying ascitic fluid into exudate or transudate than urine dipstick.

Key words: Dipstick, point of care, ascites, exudate, transudate, serum ascites albumin gradient.