Medical and psychosocial complications associated with method of bladder management after traumatic spinal cord injury
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2011, vol. 92, issue 3, pp 449-456
Study examined the effect of bladder management method on medical complications (renal calculi or decubitus ulcers), number of hospital days, and psychosocial factors in people with spinal cord injury (SCI). Data for 24,762 patients with new traumatic SCI enrolled in the National SCI Database entire data set forms I and II were analyzed. Patients were stratified according to the bladder management method recorded at each time of data collection into 1 of 4 groups as follows: indwelling catheterization, spontaneous voiding, condom catheterization, and intermittent catheterization. Medical complications, including pressure ulcer number and grade of worst ulcer, kidney stones, and hospitalizations, as well as psychosocial factors (satisfaction with life, perceived health status, societal participation), were stratified by bladder management method. Results were adjusted for level and completeness of neurologic injury and other confounding and modifying factors. Results showed that, compared with other forms of bladder management, use of an indwelling catheter was associated with more pressure ulcers and longer and more hospitalizations for all causes and urology-specific causes. Indwelling catheter use was associated with the lowest levels of participation, but similar satisfaction with life and perceived health status.
Cameron, A.P., Wallner, L.P., Forchheimer, M.B., Clemens, J.Q., Dunn, R.L., Rodriguez, G., Chen, D., Horton, J. III, and Tate, D.G.
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