Pigments test strips: a rapid companion test to exclude sub-arachnoid haemorrhage.

Abstract Objectives Subarachnoid haemorrhage (SAH) is characterised by 25% of mortality or induces long-term care. It needs immediate diagnosis with computed tomography (CT) scan. For the inconclusive CT scans, the detection of haem pigments can be performed in the cerebrospinal fluid (CSF). The reference method is spectrophotometry but it requires a large volume of CSF, and specific equipment. Sometimes, urine test strips are used as an alternative method for haem pigments detection. However, this method needs validation in SAH context. The aim of the study was to compare the performance of Multistix® urine test strips for haem pigments detection to the reference spectrophotometry and the final clinical SAH diagnosis. Methods We collected 136 CSFs sampled for suspected SAH. We detected haem pigments with urine test strips and spectrophotometry and compared performances for 100 samples. Results Urine tests strips displayed a high sensitivity (0.97) as compared to the reference spectrophotometry for haem pigments detection. Interestingly, absence of haem pigments fully correlated with absence of SAH. Conclusions Negative Multistix® urine test strips could help to exclude SAH diagnosis in combination with clinical data when a spectrophotometer is not available, or as a bedside diagnosis test.