A Negative Urinalysis is Associated with a Low Likelihood of Intra-abdominal Injury after Blunt Abdominal Trauma

• Published in: The American journal of surgery Vol. 213; no. 1; pp. 69 - 72
• Main Authors: Jones, Teresa S., MD, Stovall, Robert T., MD, Jones, Edward L., MD, Knepper, Bryan, BA, Pieracci, Fredric M., MD, Fox, Charles J., MD, Moore, Ernest E., MD, Cothren Burlew, Clay, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017; Elsevier Limited
• Subjects: Abdomen; Abdominal Injuries - diagnosis; Abdominal Injuries - urine; Adult; Aged; Blunt abdominal trauma; Blunt trauma; Colleges & universities; Female; Genitourinary; Hematuria; Humans; Injuries; Injury Severity Score; Intervention; Intra-abdominal; Male; Medical imaging; Middle Aged; Mortality; Patients; Predictive Value of Tests; Retrospective Studies; Surgery; Tomography; Urinalysis; Urogenital System - injuries; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - urine; Young Adult; intra-abdominal; blunt abdominal trauma; genitourinary; urinalysis; hematuria; blunt trauma; Genitourinary; Blunt abdominal trauma; Blunt trauma; Urinalysis; Hematuria; Intra-abdominal
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2016.05.005

Abstract Background The utility of urinalysis to diagnose intra-abdominal (IA) or genitourinary (GU) injury after blunt trauma remains controversial. The purpose of this study was to determine the significance of urinalysis in the blunt trauma patient Methods A retrospective review of patients admitted for blunt abdominal trauma from 2011-2013. Results 1795 patients sustained blunt abdominal trauma: mean age of 44±21 years; mean ISS of 13 ±10. 810 patients had a negative urinalysis (45%). Two patients (2/810, 0.2%) had a GU injury and neither required intervention. Thirty-two patients (32/810, 4.0%) had an IA injury, and two (2/810, 0.02%) required intervention. The sensitivity for predicting GU injury requiring intervention was 1 and IA injury requiring intervention was 0.96. Negative predictive values were 1 and 0.99 Conclusion A negative urinalysis correlates with a low risk for GU and IA injury after blunt abdominal trauma. A negative urinalysis should be evaluated prospectively as part of a clinical prediction score to rule out injury and avoid unnecessary radiation exposure from CT imaging.