{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:55:13Z","timestamp":1777046113777,"version":"3.51.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Screening for blunt intra-abdominal injury in children often includes directed laboratory evaluation that guides need for computed tomography. We sought to evaluate the use of urinalysis in identifying patients with clinically important intraabdominal injury (<jats:italic toggle=\"yes\">ci<\/jats:italic>-IAI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective chart review was performed for all patients less than 18 years who presented with blunt mechanisms at a level I trauma center between 2016 and 2019. Exclusion criteria included transfer from an outside facility, physical abuse, and death within thirty minutes of arrival. Demographics, physical exam findings, serum chemistries, urinalysis, and imaging were reviewed. Clinically important intraabdominal injury was defined as injury requiring \u22652 nights admission, blood transfusion, angiography with embolization, or therapeutic surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Two hundred forty patients were identified. One hundred sixty-five had a completed urinalysis. For all patients an abnormal chemistry panel and abnormal physical exam had a sensitivity of 88.9% and a negative predictive value of 99.3%. Nine patients had a <jats:italic toggle=\"yes\">ci<\/jats:italic>-IAI. Patients with a <jats:italic toggle=\"yes\">ci<\/jats:italic>-IAI were more likely to have abdominal pain, tenderness on exam, and elevated hepatic enzymes. When patients were stratified by the presence of an abnormal chemistry or physical exam with or without microscopic hematuria, urinalysis did not improve the ability to identify patients with a <jats:italic toggle=\"yes\">ci<\/jats:italic>-IAI. In fact, presence of microscopic hematuria increased the rate of false positives by 12%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Microscopic hematuria was not a useful marker for <jats:italic toggle=\"yes\">ci<\/jats:italic>-IAI and may lead to falsely assuming a more serious injury.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003210","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T01:00:08Z","timestamp":1717808408000},"page":"e139-e142","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-1288","authenticated-orcid":false,"given":"Stephanie C.","family":"Papillon","sequence":"first","affiliation":[{"name":"Department of Pediatric General, Thoracic and Minimally Invasive Surgery, St Christopher's Hospital for Children"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Pennell","sequence":"additional","affiliation":[{"name":"Department of Pediatric General, Thoracic and Minimally Invasive Surgery, St Christopher's Hospital for Children"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannara E.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aubrey","family":"DiBello","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8518-8107","authenticated-orcid":false,"given":"Sahal A.","family":"Master","sequence":"additional","affiliation":[{"name":"Department of Pediatric General, Thoracic and Minimally Invasive Surgery, St Christopher's Hospital for Children"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeev","family":"Prasad","sequence":"additional","affiliation":[{"name":"St. Luke's University Health Network, Pediatric Surgery, Bethlehem, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Grier","family":"Arthur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsh","family":"Grewal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0022-3468(96)90325-5","article-title":"Indicators of genitourinary tract injury or anomaly in cases of pediatric blunt trauma","volume":"31","year":"1996","journal-title":"J Pediatr Surg"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1097\/00000658-198812000-00003","article-title":"Hematuria. A marker of abdominal injury in children after blunt trauma","volume":"208","year":"1988","journal-title":"Ann Surg"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00383-008-2316-4","article-title":"Review of the evidence on the management of blunt renal trauma in pediatric patients","volume":"25","year":"2009","journal-title":"Pediatr Surg Int"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/01.pec.0000227381.61390.d7","article-title":"The use of routine laboratory studies as screening tools in pediatric abdominal trauma","volume":"22","year":"2006","journal-title":"Pediatr Emerg Care"},{"key":"bib5-20250504","first-page":"1306","article-title":"The utility of clinical and laboratory data for predicting intraabdominal injury among children","volume":"58","year":"2005","journal-title":"J Trauma"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00383-018-4417-z","article-title":"Variability in the evalution of pediatric blunt abdominal trauma","volume":"35","year":"2019","journal-title":"Pediatr Surg Int"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/S0090-4295(02)01548-0","article-title":"Pediatric renal trauma","volume":"59","year":"2002","journal-title":"Urology"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1016\/S0022-5347(01)65422-3","article-title":"Efficacy of radiographic imaging in pediatric blunt renal trauma","volume":"156","year":"1996","journal-title":"J Urol"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13017-019-0274-x","article-title":"Kidney and uro-trauma: WSES-AAST guidelines","volume":"14","year":"2019","journal-title":"World J Emerg Surg"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jss.2019.04.020","article-title":"Does microscopic hematuria after pediatric blunt trauma indicate clinically significant injury?","volume":"241","year":"2019","journal-title":"J Surg Res"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1007\/s00268-001-0149-6","article-title":"Radiologic evaluation of pediatric blunt renal trauma in patients with microscopic hematuria","volume":"25","year":"2001","journal-title":"World J Surg"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/00000658-199103000-00005","article-title":"Indications for computed tomography in children with blunt abdominal trauma","volume":"213","year":"1991","journal-title":"Ann Surg"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"569","DOI":"10.2214\/ajr.154.3.2106223","article-title":"The significance of hematuria in children after blunt abdominal trauma","volume":"154","year":"1990","journal-title":"AJR Am J Roentgenol"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.urology.2010.05.014","article-title":"Use of adult criteria for slice imaging may limit unnecessary radiation exposure in children presenting with hematuria and blunt abdominal trauma","volume":"77","year":"2011","journal-title":"Urology"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/j.1553-2712.1999.tb01210.x","article-title":"Identification of intra-abdominal injuries in children hospitalized following blunt torso trauma","volume":"6","year":"1999","journal-title":"Acad Emerg Med"},{"key":"bib16-20250504","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1067\/mem.2002.122900","article-title":"Identification of children with intra-abdominal injuries after blunt trauma","volume":"39","year":"2002","journal-title":"Ann Emerg Med"},{"key":"bib17-20250504","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.annemergmed.2009.01.019","article-title":"Validation of a prediction rule for the identification of children with intra-abdominal injuries after blunt torso trauma","volume":"54","year":"2009","journal-title":"Ann Emerg Med"},{"key":"bib18-20250504","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1097\/TA.0000000000003206","article-title":"Hospital-based intervention is rarely needed for children with low-grade blunt abdominal solid organ injury: an analysis of the trauma quality improvement program registry","volume":"91","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"bib19-20250504","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1097\/TA.0000000000002899","article-title":"Isolated low-grade solid organ injuries in children following blunt abdominal trauma: is it time to consider discharge from the emergency department?","volume":"89","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"bib20-20250504","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/j.1464-410X.2004.04868.x","article-title":"Renal trauma: indications for imaging and surgical exploration","volume":"93","year":"2004","journal-title":"BJU Int"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:10:30Z","timestamp":1746382230000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003210","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,7]]}}}