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

Trauma is the most common cause of death under the age of 50, 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.

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 2016 and 2017. Patients with blunt abdominal trauma aged 18 to 65 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<0.05) was considered significant.

In this study, 400 patients with blunt trauma participated. The frequency of microscopic hematuria in patients with intra-abdominal organ damage was significantly higher than in other patients (71.4% versus. 38.9%, P<0.001). The sensitivity and specificity of microscopic hematuria in diagnosing damage to intra-abdominal organs were 53.84% and 77.14%, respectively. The overall accuracy of the test was 62.0% (Kappa coefficient=0.22, P<0.001).

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.