Urinary Symptoms are Unrelated to Dipstick Findings in Indwelling Catheter Users: Supplemental Material
Creators: name: Rounds, Amanda
name: Tractenberg, Rochelle
name: Groah, Suzanne
name: Frost, Jamie
name: Ljungberg, Inger
name: Navia, Herminio
name: Pham, Cynthia
Publisher: name: figshare
Year: 2021
Subjects: subject: Diseases
subject: 110904 Neurology and Neuromuscular Diseases
subject: FOS: Clinical medicine
subject: 110312 Nephrology and Urology

description: The dipsticks had only two possible outcomes for nitrites (NIT): positive (NIT+) or negative (NIT-), and five different outcomes for leukocyte esterase (LE): negative; trace; small; moderate; or large. Thus, while there was only one way to define “NIT+”, there were <i>multiple</i> possible definitions of a “positive LE” dipstick outcome: 1) NOT negative; 2) NOT negative OR trace; 3) moderate OR large; 4) large. The LE outcome “small” was deemed to be insufficiently clearly “negative” or “positive” to base an outcome on it, so LE=small was the foundation for our consideration of an “indeterminate” LE (and dipstick) result. We explored the four definitions of “LE+”, both as independent of NIT and together with it. Figures 1A and 1B show that no matter which of the four “positive LE” definitions we used, there is no evidence that symptoms of bladder function (B1) or urine quality (B2) co-occur with either positive NIT, positive LE (however defined), or both positive. Based on these exploratory data analyses and the challenge of interpreting LE=small, we operationally defined “positive LE” to be LE moderate or large (definition 3), and thus “positive dipstick” was defined as “NIT+ and LE moderate or large”. This is the definition of “positive” used throughout the manuscript. It is important to note that the data available for these analyses decreases with increasingly more stringent LE+ definitions.<b>Burden</b> of A, B1 and B2 symptoms were estimated each week using the burden calculation.<sup>1</sup> The boxplots show the distribution of values in each week; the box itself captures the 25<sup>th</sup> to 75<sup>th</sup> percentile values and values falling more than three standard deviations from the mean are shown as dots. The average burden from A symptoms over the entire study was 5.29%±13.0 (range 0-88.9%), with a median of zero in every week. The figure shows that in 7/26 weeks, 50% of the sample experienced <i>some</i> burden of A symptom type, although A type symptom burden was generally low in this cohort every week. The weekly burden of B1 symptoms was zero for most (75% or more) of the sample in every study week, so any values greater than zero appear as outliers in the figure. By contrast, B2 symptom burden had an average of 15.0%±26.2 (range 0-100%) over the entire study period; in five of the study weeks most of the sample experienced no B2 symptom burden. We explored the association between strong positive dipstick results and A type symptoms. We assessed the distributions of the % of the time (of 26 weeks) an individual had co-occurrence of an A symptom (in the presence of others, or not) and a strong positive dipstick. All co-occurrence of A symptoms with strong positive dipsticks was below 25%: we found no evidence of a relationship with clinically actionable symptoms Figure 3: Boxplot distributions of the number of times a subject had A symptoms and a “positive dipstick” (LE+ (Mod or Large) AND NIT+).<br>