Predictive value of microscopic hematuria in the diagnosis of intra-abdominal organ damage in blunt trauma

Introduction:Trauma is the most common cause of death under the age of ۵۰, and one of the three main causes of death. The role of microscopic hematuria in the diagnosis of abdominal injuries is not clear. This study aimed to investigate the predictive role of microscopic hematuria in the assessment of abdominal organ damage in blunt trauma. Methods: This cross-sectional study was conducted on all blunt trauma patients, who were admitted to the surgery department of Shahid Beheshti Hospital in Kashan in ۲۰۱۶ and ۲۰۱۷. Patients with blunt abdominal trauma aged ۱۸ to ۶۵ years were included, and patients with macroscopic hematuria, unstable hemodynamic status, and a history of kidney diseases were excluded. Spiral CT scan of the abdomen and pelvis was performed with intravenous injection of contrast material with delayed nephrogram phase as the gold standard. Data analysis was performed using the SPSS software. The Chi-square test, and McNemar's test were used. (P<۰.۰۵) was considered significant. Results: In this study, ۴۰۰ patients with blunt trauma participated. The frequency of microscopic hematuria in patients with intra-abdominal organ damage was significantly higher than in other patients (۷۱.۴% versus. ۳۸.۹%, P<۰.۰۰۱). The sensitivity and specificity of microscopic hematuria in diagnosing damage to intra-abdominal organs were ۵۳.۸۴% and ۷۷.۱۴%, respectively. The overall accuracy of the test was ۶۲.۰% (Kappa coefficient=۰.۲۲, P<۰.۰۰۱). Conclusion: Due to the low accuracy of microscopic hematuria in diagnosing damage to intra-abdominal organs, it is not suitable as the main diagnostic method, but it can be used as an auxiliary method.

Keywords:

Abdominal Injuries , Blunt Trauma , Evaluation , Hematuria