759 - Clinical Factors Associated With Urethritis in the Emergency Department
Friday, May 15, 2020
9:12 AM – 9:18 AM
Location: Majestic Ballroom: Majestic
Participants should be aware of the following financial/non-financial relationships:
Santiago Cantillo-Campos, n/a: No financial relationships or conflicts of interest
Justin M. Elkins: No financial relationships or conflicts of interest
Johnathan M. Sheele, MD, MPH, MHS: No disclosure data submitted.
Santiago Cantillo Campos: No disclosure data submitted.
Background and Objectives: Urethritis is associated with sexually transmitted diseases and may be classified as gonococcal or non-gonococcal. The objective of the study was to determine the variables associated with male emergency department (ED) patients with urethritis.
Methods: A retrospective analysis of male ED patients ≥18 years of age that presented to a single health system in northeast Ohio between 2012 and 2017, who underwent nucleic acid amplification testing for Chlamydia trachomatis or Neisseria gonorrhoeae and/or a urinalysis and urine culture, was performed. Subjects with ED discharge international classification of diagnosis (ICD) codes for urethritis and penile discharge (R36.9, N34.1, N34.2, A54.01, A56.01, 788.7, 099.40, 597.80, 597.89, 098.11, 098.31, 099.53, 595.4) were compared to those not receiving that diagnosis. Descriptive statistics, including percentages, means, and standard deviations, were calculated. Categorical variables were analyzed by the chi-square test and continuous variables by the independent t-tests. Logistic regression analysis was adjusted for age, race, urine leukocyte esterase, urine blood, and having N. gonorrhoeae and/or C. trachomatis.
Results: There were 19,308 medical encounters, of which 4.5% (862/19,308) were diagnosed with urethritis. Patients with urethritis, compared to those without it, were younger [29.3 (10.1) vs 59.2 (21.8)], more likely to be black (92% vs 45%), not-married (93% vs 59%), and infected with C. trachomatis (20% vs 13%) and N. gonorrhoeae (27% vs 9%). Patients with urethritis were less likely to have primary care physicians (16% vs 43%) and urinary tract infection (1.6% vs 14%). On regression analysis, urine blood [OR 0.70 (0.57-0.86)], urine leukocyte esterase [OR 1.34 (1.19-1.54)], age [OR 0.98 (0.97-0.99)], race [OR 14.4 (11.2-18.5)], infection with N. gonorrhoeae [OR 3.55 (2.87-4.40)], and infection with C. trachomatis [OR 1.62 (1.31-2.02)] was associated with urethritis.
Conclusion: Clinical information available in the ED encounter, in combination with urinalysis results, may help identify subjects at increased risk of urethritis. Infection with N. gonorrhoeae increased the odds of urethritis more than infection with C. trachomatis. On logistic regression, a younger age, black race, positive leukocyte esterase, and absence of blood in urine were associated with urethritis.