title: A negative urinalysis is associated with a low likelihood of intra-abdominal injury after blunt abdominal trauma.
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.
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Teresa S
authors.initials: TS
authors.lastname: Jones
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Stovall
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Jones
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Knepper
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Fredric M
authors.initials: FM
authors.lastname: Pieracci
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Fox
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA.
authors.forename: Ernest E
authors.initials: EE
authors.lastname: Moore
authors.affiliation: Department of Surgery, Denver Health Medical Center, the University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO 80204, USA. Electronic address: clay.cothren@dhha.org.
authors.forename: Clay
authors.initials: C
authors.lastname: Cothren Burlew
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000652:urine; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016482:Urinalysis; D014566:Urogenital System / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000652:urine; D055815:Young Adult
keywords: Blunt abdominal trauma; Blunt trauma; Genitourinary; Hematuria; Intra-abdominal; Urinalysis