The accuracy of various types of urinalysis in terms of predicting intra-abdominal injury in emergency trauma patients: A diagnostic accuracy study


1 Prehospital and Hospital Emergency Research Center; Department of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Emergency Medicine, Sina Hospital; Department of School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Prehospital and Hospital Emergency Research Center; Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran


Background and Objectives: Given the importance and prevalence of trauma patients in the emergency department and the questioning of urinalysis value in predicting intra-abdominal injury, this study was conducted to examine the accuracy of various types of this test. Methods: This diagnostic accuracy study was conducted on adult patients with abdominal trauma. Data gathering were performed retrospectively until sample size completion using a preprepared checklist. Required data, including demographic characteristics, diseases confounding urinalysis, trauma mechanism, important associated injuries, vital signs, etc., were recorded. Accuracy of urinalysis (including macroscopic, microscopic and dipstick) results was compared with findings of patients' enhanced computed tomography (CT) scan findings that was considered as the gold standard, reported by a radiologist. Results: Totally, 152 multiple trauma patients with the mean age of 37.9 ± 17.7 years were enrolled (90.8% males), of whom 66 (43.42%) patients had hematuria and the CT scan was abnormal in 30 (19.73%) cases. There was a significant correlation between gross hematuria and abnormal CT scan (P < 0.01) as opposed to microscopic or dipstick hematuria (P > 0.05). Based on the findings, the highest sensitivity was for dipstick and microscopic equally and highest specificity, positive predictive value, negative predictive value, positive and negative likelihood ratios, NLR and accuracy were for the gross test. Conclusions: Microscopic hematuria and dipstick had no significant correlation with abnormal CT scan findings and cannot predict the intra-abdominal injuries in multiple trauma patients. But, macroscopic hematuria could be valuable in this regard.


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