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PM.35 Changing from 24-Hour Urinary Protein Collections to Protein-Creatinine Ratios: An Audit of One Hospital’s Experience of Trying to Reduce Admission Rates For Pre-Eclampsia
  1. JL Sinclair,
  2. W Ogunnoiki,
  3. G Lawson
  1. Tunbridge Wells Hospital, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK

Abstract

Background Traditionally, 24-hour urinary protein collection has been used to quantify proteinuria in pre-eclampsia. There has been a move in recent years towards a “spot test” protein creatinine ratio (PCR) instead. The study hospital changed to PCR in December 2011. The audit was carried out to cheque that the department was following local and NICE Hypertension in Pregnancy guidelines and to see if there was a reduction in antenatal admission rates.

Methods The retrospective audit was carried out over two months. Data was collected from two periods – October to November 2011 (before introduction of PCR) and January to March 2012 (after introduction of PCR). Cases were identified from biochemistry department records. Data was collected on appropriate ordering and processing of tests, admission rates and length of stay in hospital. The ordering and processing of tests were compared with 95% standards. Admission rates were compared using Fisher’s exact test and an odds ratio calculated. Lengths of stay were compared using a one-tailed Mann Whitney U test.

Results Patients from the PCR group were significantly less likely to be admitted to hospital (p = 0.017, odds ratio 0.2) and if admitted, length of stay was significantly shorter (p = 0.027).

Conclusions The significantly reduced admission rates and length of stay associated with the PCR group suggests that the diagnostic move from 24-hour urinary protein collection to PCR was beneficial to the department.

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