The Value of Urinalysis in Detection of Abdominal Organ Injuries in Children with Hematuria Following Blunt Abdominal Trauma; A Diagnostic Study

Authors

1 Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Pediatric Specialist, Private Researcher, Tehran, Iran.

4 Department of Radiology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Department of Emergency Medicine, Sina Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background
Currently, almost all patients with probable abdominal injury undergo urinalysis in emergency department (ED). The present survey was conducted with the aim of assessing the diagnostic values of urinalysis compare with abdominal computed tomography (CT) scan with contrast for predicting possible intra-abdominal injuries in children affected by blunt trauma.
Materials and Methods: The present diagnostic accuracy study was accomplished on patients' < 16-year-old with blunt abdominal trauma who were admitted to emergency department (ED) and underwent both urinalysis and abdominal CT scan. Demographic and baseline characteristics data, and the results of urinalysis and abdominal CT scan were recorded. Thereafter, screening performance characteristics were calculated.
Results
Seventy eligible patients with the mean age of 7.1 ± 4.86 years were enrolled (68.6% male). Screening performance characteristics including sensitivity, specificity and positive and negative predictive values of hematuria were 26.7%, 92.7%, 50.0% and 82.3%, respectively. Positive and negative likelihood ratios were calculated as 3.67 and 0.79, respectively.
Conclusion
It is likely that, presence of hematuria has acceptable specificity, but very low sensitivity in comparison with CT scan for prediction of abdominal organ injuries in children with blunt abdominal trauma. Therefore, urinalysis is not useful for screening the presence of organ injuries in this population.

Keywords