Association of Clinical Signs and Symptoms with Abnormal Urinalysis Findings of Blunt Trauma Patients; a Cross-Sectional Study
学术急诊医学档案,
卷 7 编号 1 (2019),
1 十月 2019
,
第 e64 页
https://doi.org/10.22037/aaem.v7i1.419
摘要
Introduction: Urinalysis (UA) is performed routinely as a diagnostic screening test for trauma patients in most centers. This study aimed to examine the relationship between patients’ clinical signs and symptoms with UA findings. Methods: This cross-sectional study was carried out on multiple trauma patients between 18 to 65 years old, who were referred to the Emergency Department. UA was performed for all patients and its association with clinical signs and symptoms (pain, tenderness, abrasion, ecchymosis, hematoma, etc.) in abdomen, back, flank, and inferior hemi-thorax was evaluated.Results: 640 patients with the mean age of 39.8 ± 11.2 years were studied (65.0% males). 271 (42.4%) cases had associated injuries and 554 (86.6%) cases had at least one sign or symptom of trauma in abdomen, back, flank or inferior hemi-thorax. 146 (22.8%) patients had negative UA. Among cases with positive UA, 364 (56.9%) cases had microscopic hematuria with RBC < 25/HPF, 60 (9.4%) had microscopic hematuria with RBC ≥ 25/HPF and 70 (10.9%) had gross hematuria. None of the asymptomatic patients had microscopic hematuria with RBC ≥ 25/HPF and gross hematuria (p <0.001). Symptomatic patients who had signs in the abdomen, back or inferior hemi-thorax mainly had microscopic hematuria with RBC < 25/HPF, but those with signs in the flank, mainly had microscopic hematuria with RBC ≥ 25/HPF (p<0.001). Patients with pain, tenderness, abrasion, and ecchymosis in flank had a higher risk of positive UA findings (figure 2; p <0.001).Conclusion: Based on the findings of the present study, patients with any findings of pain, tenderness, abrasion, or ecchymosis in flank had higher risk of abnormal UA and perhaps urogenital injuries. None of the asymptomatic patients had microscopic hematuria with RBC ≥ 25/HPF and gross hematuria.
- Urinalysis
- urogenital system
- hematuria
- multiple trauma
- signs and symptoms
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参考
Walls R, Hockberger R, Gausche-Hill M. Rosen's Emergency Medicine-Concepts and Clinical Practice E-Book: Elsevier Health Sciences; 2017.
Curry N, Davis P. What's new in resuscitation strategies for the patient with multiple trauma? Injury. 2012;43(7):1021-8.
Organization WH. Violence, injuries and disability: biennial report 2008-2009. 2010.
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. The lancet. 1997;349(9063):1436-42.
Rice DP. Cost of injury in the United States: a report to Congress, 1989: Institute for Health & Aging, University of California, San Francisco; 1989.
Tan W, Chen C, Chiang H. The value and role of computed tomography in blunt injury of the abdomen. Zhonghua yi xue za zhi= Chinese medical journal; Free China ed. 1991;48(2):116-20.
McAninch JW. Genitourinary trauma. Urologic Clinics. 2006;33(1):xiii.
Poletti PA, Mirvis SE, Shanmuganathan K, Takada T, Killeen KL, Perlmutter D, et al. Blunt abdominal trauma patients: can organ injury be excluded without performing computed tomography? Journal of Trauma and Acute Care Surgery. 2004;57(5):1072-81.
Bregstein JS, Lubell TR, Ruscica AM, Roskind CG. Nuking the radiation: minimizing radiation exposure in the evaluation of pediatric blunt trauma. Current opinion in pediatrics. 2014;26(3):272-8.
Santucci R, Wessells H, Bartsch G, Descotes J, Heyns C, McAninch J, et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU international. 2004;93(7):937-54.
Wright JL, Nathens AB, Rivara FP, Wessells H. Renal and extrarenal predictors of nephrectomy from the national trauma data bank. The Journal of urology. 2006;175(3):970-5.
Holmes JF, Wisner DH, McGahan JP, Mower WR, Kuppermann N. Clinical prediction rules for identifying adults at very low risk for intra-abdominal injuries after blunt trauma. Annals of emergency medicine. 2009;54(4):575-84.
Jones TS, Stovall RT, Jones EL, Knepper B, Pieracci FM, Fox CJ, et al. A negative urinalysis is associated with a low likelihood of intra-abdominal injury after blunt abdominal trauma. The American Journal of Surgery. 2017;213(1):69-72.
Sabzghabaei A, Shojaee M, Safari S, Hatamabadi HR, Shirvani R. The accuracy of urinalysis in predicting intra-abdominal injury following blunt traumas. Emergency. 2016;4(1):11.
Moustafa F, Loze C, Pereira B, Vaz M, Caumon L, Perrier C, et al. Assessment of urinary dipstick in patients admitted to an ED for blunt abdominal trauma. The American journal of emergency medicine. 2017;35(4):628-31.
Olthof DC, Joosse P, van der Vlies CH, de Reijke TM, Goslings JC. Routine urinalysis in patients with a blunt abdominal trauma mechanism is not valuable to detect urogenital injury. Emerg Med J. 2015;32(2):119-23.
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