For a study, researchers sought to assess the effects of bladder management techniques, specifically chronic indwelling catheters (IndC), on patients’ survival after spinal cord injury (SCI) in the Spinal Cord Injury Model System database.
The Spinal Cord Injury Model System has more than 40,000 SCI patients in its multicenter longitudinal database since 1970. Patients who were (>18 at the time of injury) when the accident occurred were screened. Patients who had 2 or more bladder management technique changes, died within a year of the injury or reported a normal voluntary void were excluded from the study. Death from nonpulmonary, nonwound related sepsis (NPNWS) was the outcome of interest. The hazard ratios were calculated using the left truncation cox regression approach with age as the time scale.
The study included 13,616 patients in all. Comparison was made between the “IndC” group (n=4,872; 36.1%) and the “Other” group (n= 8,744; 63.9%). “IndC” was linked with higher NPNWS mortality after controlling for age and changes in bladder management technique (2.10; 95% CI: 1.72-2.56, P<.001). IndC was associated with a significantly higher risk of death from NPNWS compared to other bladder management techniques, according to multivariable analysis that controlled for age at injury, gender, race, education level, insurance status, etiology of SCI, injury level, neurologic impairment level, and change in bladder management method.
When compared to alternative bladder management techniques, bladder management using IndC was considerably more predictive of propagating NPNWS-related mortality in a large cohort of SCI patients. A greater comprehension of the underlying processes should help to develop ways to enhance neurological treatment and survival after SCI, even though detecting IndC is a standalone mortality risk factor.