Bladder emptying method is the primary determinant of urinary tract infections in patients with spinal cord injury: results from a prospective rehabilitation cohort study.
Adolescent
Adult
Aged
Catheters, Indwelling
/ adverse effects
Female
Humans
Incidence
Intermittent Urethral Catheterization
/ adverse effects
Length of Stay
Male
Middle Aged
Prospective Studies
Risk Factors
Self Care
/ adverse effects
Spinal Cord Injuries
/ complications
Switzerland
/ epidemiology
Urinary Bladder, Neurogenic
/ complications
Urinary Tract Infections
/ epidemiology
Urination
Young Adult
neurogenic
neurological rehabilitation
spinal cord injuries
urinary bladder
urinary catheters
urinary tract infections
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
pubmed:
17
8
2018
medline:
29
9
2019
entrez:
17
8
2018
Statut:
ppublish
Résumé
To understand the occurrence of and risk factors for urinary tract infections (UTIs) in patients with spinal cord injury (SCI) undergoing specialized SCI rehabilitation in Switzerland. This study used data collected from 369 patients, who participated in a nationwide rehabilitation cohort for SCI in Switzerland between 2013 and 2017. Information on UTIs as well as their potential determinants, including demographics, lesion characteristics, and time-updated data on functional independence and bladder management, was used. Multivariable regression methods were applied to perform a time-updated evaluation of determinants of UTI risk. The crude incidence rate (IR) of UTIs was 0.55 UTIs per 100 person-days (95% confidence interval [CI] 0.49-0.62), the cumulative IR was 43%, and the median length of stay was 122 days. The bladder emptying method at discharge was largely determined by 28 days after admission. Among those using indwelling or assisted intermittent catheterization (IC), the likelihood of self-IC at discharge was positively related to the level of self-care independence, negatively related to age at injury, and lower in women than men. Catheter users consistently had higher adjusted IRs for UTI than spontaneous voiders. The IR ratios were: indwelling catheter: 5.97 (95% CI 2.63-13.57); assisted IC: 6.05 (95% CI 2.63-13.94); self-IC: 5.16 (95% CI 2.31-11.52); test for differences across catheter groups: P = 0.82. Lesion severity and previous UTI had additional but smaller effect sizes. Bladder emptying method was identified as the main risk factor for UTI in patients with SCI. As spontaneous voiders had the lowest UTI rate, further research is warranted to reduce voiding dysfunction, for instance using neuromodulation procedures.
Banques de données
GENBANK
['PB_2016']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
342-352Investigateurs
Bertrand Léger
(B)
Michael Baumberger
(M)
Peter Gmünder
(P)
Armin Curt
(A)
Margret Hund-Georgiadis
(M)
Kerstin Hug
(K)
Thomas Troger
(T)
Daniel Joggi
(D)
Hardy Landolt
(H)
Nadja Münzel
(N)
Mirjam Brach
(M)
Gerold Stucki
(G)
Martin Brinkhof
(M)
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.