evaluation of intoxication in patients with acute impaired consciousness using rapid urine test tape; a diagnostic accuracy study

Objective: determining the exact underlying etiology of loss of consciousness (loc) can become a real challenge for physicians due to the broadness of differential diagnoses. the current study aimed to assess the accuracyof a commercially available strip for urine drug screening, in patients presenting with loc.methods: one hundred fifty patientswith locwere enrolled in the current cross-sectional study. the diagnostic accuracy of a multidrug urinary strip rapid test was evaluated in comparison to blood analysis as the referencetest, and the screening performance characteristics of the rapid test for each substance were estimated.results: the average age of patients was 46.21±18.59 years (72.67% male). the most frequent false positiveresults of the test were related to benzodiazepine (21.5%), methamphetamine (7.5%), and tramadol (5.4%), respectively. the screening performance characteristics of the test tape were the best in detection of amitriptylinewith 100.0% (95% ci: 30.99 – 100.0) sensitivity, cocaine with 100.0% (95% ci: 5.46 – 100.0) sensitivity, andmethadone with 91.54% (95% ci: 81.88 – 96.51) sensitivity, respectively.conclusion: the current study reveals that employing a urinary strip test for detecting drug intoxication in thesetting of emergency department can lead to significant false positive and negative results. accordingly, relyingon a urine drug screen to determine the underlying etiology of loc should be done with caution.