• Nidhi V Singh, Katrin Lichtsinn, Molly Ray, Karla A Lawson, Karen Piper, and Matthew H Wilkinson.
• From the Division of Pediatric Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
• Pediatr Emerg Care. 2024 Jul 1; 40 (7): 547550547-550.

BackgroundIntra-abdominal injury (IAI) is the second leading cause of mortality in abused children. It is challenging to identify in young patients due to their limited verbal skills, delayed symptoms, less muscular abdominal wall, and limited bruising.MethodsWe conducted a retrospective cohort study of children aged 0 to 12 months who were evaluated in the emergency department for suspected child abuse with a skeletal survey and urinalysis between January 1, 2015, and December 31, 2017. Our primary objective was to identify the proportion of IAI cases identified by urinalysis alone (>10 RBC/HPF) and not by examination findings or other laboratory results. A secondary objective was to quantify potential delay in disposition while waiting for urinalysis results, calculated as the length of time between receiving skeletal survey and laboratory results and receiving urinalysis results.ResultsSix hundred thirteen subjects met our inclusion criteria; two subjects had hematuria, one of whom had a urinary tract infection. The other was determined to have blood from a catheterized urine specimen. One subject was found to have an IAI. We further found that urinalysis was delayed for 78% of subjects and took a median of 93 [interquartile range, 46-153] minutes longer than imaging and/or laboratories.ConclusionsNo subjects were diagnosed with abdominal trauma based on urinalysis during evaluation in the emergency department who would not have been identified by other standard testing. In addition, patients' disposition was delayed while waiting for urinalysis.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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