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  • Title: A negative urinalysis is associated with a low likelihood of intra-abdominal injury after blunt abdominal trauma.
    Author: Jones TS, Stovall RT, Jones EL, Knepper B, Pieracci FM, Fox CJ, Moore EE, Cothren Burlew C.
    Journal: Am J Surg; 2017 Jan; 213(1):69-72. PubMed ID: 27452187.
    Abstract:
    BACKGROUND: The utility of urinalysis (UA) 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 UA in the blunt trauma patient. METHODS: A retrospective review of patients admitted for blunt abdominal trauma from 2011 to 2013. RESULTS: A total of 1,795 patients sustained blunt abdominal trauma: mean age of 44 ± 21 years; mean Injury Severity Score of 13 ± 10. Overall 810 patients had a negative UA (45%). Two patients (2/810 and .2%) had a GU injury and neither required intervention. Thirty-two patients (32/810 and 4.0%) had an IA injury, and 2 (2/810 and .02%) required intervention. The sensitivity for predicting GU injury requiring intervention was 1, and IA injury requiring intervention was .96. Negative predictive values were 1 and .99. CONCLUSIONS: A negative UA correlates with a low risk for GU and IA injury after blunt abdominal trauma. A negative UA should be evaluated prospectively as part of a clinical prediction score to rule out injury and avoid unnecessary radiation exposure from computed tomography imaging.
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