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Self-Reported Urologic Hospitalizations or Emergency Room Visits in a Contemporary Spinal Cord Injury Cohort.

PURPOSE
Individuals with SCI frequently utilize urgent and emergent medical care. We hypothesized that urologic causes are a primary driver of hospitalizations/ER visits in a contemporary SCI cohort.


MATERIALS AND METHODS
The Neurogenic Bladder Research Group SCI registry is a prospective cohort study, evaluating neurogenic bladder-related quality of life after traumatic SCI. Questionnaires were administered to participants querying whether a hospitalization or ER visit occurred during the interval one year follow-up, and reason for visit. Primary outcome was the rate of urologic related hospitalizations/ER visits over one year. Multivariable logistic regression was used to identify risk factors for urologic related hospitalization/ER visit.


RESULTS
Of the 1479 participants enrolled, 1260 had one-year follow up. Fourteen percent (211/1260) reported at least one urologic hospitalization/ER visit and UTIs were the most common reason cited. Patients with an indwelling catheter had the greatest odds of having a hospitalization/ER episode for a urologic indication (OR=3.35, CI:1.68-6.67, p=0.001), followed by CIC (OR=2.56, CI:1.36-4.84, p=0.004) as compared to those who voided spontaneously. Other predictors included SF-12 physical scores (OR=0.98, CI:0.96-0.996, p=0.014), diminished hand function (OR=1.83, CI:1.05-3.19, p=0.033), and unemployment (OR=1.64, CI:1.13-2.37, p=0.009).


CONCLUSIONS
There was a high incidence of hospitalizations/ER visits for SCI patients over a one-year follow-up and urologic complications were the most common reason for admission. Patient self-reported physical health as well as unemployment, and bladder management strategy, particularly indwelling catheter use, were associated with increased risk of urologic related hospitalization/ER visits.