Analysis of the factors influencing development of urinary tract infections in patients with spinal cord injuriеs

Sekulić, Aleksandra; Nikolić, Aleksandra; Bukumirić, Zoran; Trajković, Goran; Ćorac, Aleksandar; Janković, Slobodan; Milićević, Saša

doi:10.2298/vsp140725116s

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…The length of hospitalisation was greater in patients with UTI, which was consistent with other studies (Conradsson et al, 2019;Evans et al, 2008;Goodes et al, 2020;Sekulic et al, 2015).…”

Section: Relationships Between Length Of Hospitalisation and Utisupporting

confidence: 91%

“…The presence of an indwelling catheter increased the risk of UTI. This result is consistent with those of some previous studies (Everaert et al, 2009;Krebs et al, 2016;Togan et al, 2014), but inconsistent with others demonstrating a higher incidence of UTI in patients with intermittent catheterisation (Sekulic et al, 2015;Shin et al, 2008). These conflicting results may be due to the difference in the duration of neurogenic bladder or the definition of UTI, including asymptomatic UTI (Krebs et al, 2016).…”

Section: Factors Affecting Utisupporting

confidence: 86%

“…Sex was a significant factor affecting contraction of UTI. This was not in accordance with previous studies, which reported that sex was not associated with UTI (Han & Lee, 2005;Krebs et al, 2016;Moon, 2007;Sekulic et al, 2015;Shin et al, 2008;Togan et al, 2014). Edokpolo et al, (2012) pointed out that females represent the minority among patients with SCI; therefore, it is difficult to compare the results of complications, including UTI in male and female patients (Edokpolo et al, 2012).…”

Section: Factors Affecting Uticontrasting

confidence: 56%

“…Author (year), country UTI associated with UTI not associated with Factors considered in this study Togan et al (2014), Turkey Type of bladder emptying Sex, age, neurological level Sex, age, duration of injury, presence of comorbidity, aetiology, completeness of injury, neurological level, type of neurogenic bladder, type of bladder emptying, anaemia (haemoglobin: g/dL) and urine specific gravity Sekulic et al (2015), Serbia Age, aetiology, neurological level, completeness of injury, type of neurogenic bladder, type of bladder emptying, anaemia Sex Krebs et al (2016), Switzerland…”

Section: Ta B L E 1 Risk Factors For Urinary Tract Infection In Patients With Spinal Cord Injury Investigated Previouslymentioning

confidence: 99%

“…Overactive detrusor is characterised by involuntary detrusor contractions (Middleton et al, 2014). As cases of UTI with an overactive bladder may be caused by the high risk of reflux (Jahromi et al, 2014;Sekulic et al, 2015), anticholinergic medications to relax overactive detrusor are usually recommended to maintain bladder compliance and capacity (Middleton et al, 2014;Salameh et al, 2015). The most frequently prescribed anticholinergic medication is oxybutynin hydrochloride (Middleton et al, 2014;Park & Moon, 2012).…”

Section: Factors Affecting Utimentioning

confidence: 99%

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Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Kim

Cho

et al. 2021

Journal of Clinical Nursing

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Aims and objectives: To investigate the incidence of urinary tract infection and analyse its risk factors among hospitalised patients with spinal cord injury.Background: While the incidence of urinary tract infection varies widely according to the healthcare setting and patients' clinical characteristics, formal reports are limited in quantity. There has been no consensus regarding the risk factors for urinary tract infection.Design: A retrospective descriptive study.Methods: Electronic medical records of 964 subjects between 2010-2017 were reviewed. Urinary tract infection status was examined to identify newly occurred cases.Data included demographic and clinical characteristics, hydration status and length of hospitalisation. The reporting of the study followed the EQUATOR Network's STROBE checklist.Results: Of the sample, 31.7% had urinary tract infection (95% confidence interval:1.288 to 1.347, p < .001). Sex, completeness of injury, type of bladder emptying, detrusor function and urethral pressure were significant factors affecting urinary tract infection. Patients who were male and those with injury classifications A, B and C had higher risk of urinary tract infection. Patients with urinary or suprapubic indwelling catheters, as well as those with areflexic detrusor combined with normotonic urethral pressure or overactive detrusor combined with normotonic urethral pressure, showed higher risk. Length of hospitalisation in patients with urinary tract infection was greater than that in uninfected patients, which implies the importance of prevention of urinary tract infection. Conclusions: Nurses should carefully assess risk factors to prevent urinary tract infection in patients with spinal cord injury in the acute and sub-acute stages of the disease trajectory and provide individualised nursing care. Relevance to clinical practice: This study contributes evidence for up-to-date clinical nursing practice for the comprehensive management of urinary tract infection. This can lead to improvements in nursing care quality and patient outcomes, including length of hospitalisation. | 2069 KIM et al. | INTRODUC TI ONUrinary tract infection (UTI) is currently the most common infection following spinal cord injury (SCI) (

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“…The length of hospitalisation was greater in patients with UTI, which was consistent with other studies (Conradsson et al, 2019;Evans et al, 2008;Goodes et al, 2020;Sekulic et al, 2015).…”

Section: Relationships Between Length Of Hospitalisation and Utisupporting

confidence: 91%

Section: Factors Affecting Utisupporting

confidence: 86%

Section: Factors Affecting Uticontrasting

confidence: 56%

Section: Ta B L E 1 Risk Factors For Urinary Tract Infection In Patients With Spinal Cord Injury Investigated Previouslymentioning

confidence: 99%

Section: Factors Affecting Utimentioning

confidence: 99%

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Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Kim

Cho

et al. 2021

Journal of Clinical Nursing

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A nomogram for predicting the hospital-acquired infections in children with spinal cord injuries: a retrospective, multicenter, observational study

Wang,

Zheng,

Zhang

et al. 2024

Spinal Cord

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Is It Really the Foley? A Systematic Review of Bladder Management and Infection Risk

Davis¹,

Jethani²,

Robbins³

et al. 2023

Topics in Spinal Cord Injury Rehabilitation

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Background The belief that intermittent catheterization results in fewer infections than indwelling catheters is commonly expressed in the spinal cord injury literature. Some practice guidelines strongly recommend intermittent over indwelling catheterization due to concerns about infections and other complications. However, studies on this topic are of low quality. Guidelines from the Consortium for Spinal Cord Medicine suggest the data regarding infection risk are mixed, and they do not recommend one bladder management method over the other. Objectives To compare risk of bias in studies reporting higher rates of urinary tract infection (UTI) with indwelling catheters to studies that found equal rates of UTI between indwelling and intermittent catheterization, and to describe implications in clinical decision-making. Methods A systematic search of PubMed, CINAHL, Embase, and SCOPUS databases from January 1, 1980, to September 15, 2020, was conducted. Eligible studies compared symptomatic UTI rates between indwelling and intermittent catheterization. We used a risk of bias assessment tool to evaluate each study. Results Twenty-four studies were identified. Only three of these reported significantly higher UTI risk with indwelling catheters, and all three demonstrated a critical risk of bias. More than half of the studies reported differences in UTI risk of less than 20% between the two methods. Studies with larger (nonsignificant) differences favoring intermittent catheterization were more susceptible to bias from confounding. Conclusion The hypothesis that indwelling catheters cause more UTIs than intermittent catheterization is not supported by the scientific literature. Most studies failed to demonstrate a significant difference in UTI risk, and studies with nonsignificant trends favoring intermittent catheterization were more susceptible to bias from confounding. Perceived risk of infection should not influence a patient’s choice of catheter type.

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Analysis of the factors influencing development of urinary tract infections in patients with spinal cord injuriеs

Abstract: The physicians should take precautions and try to make the early diagnosis and rapid appropriate treatment of urinary tract infections in patients with SCI who also have functional bladder disorder, combined spinal injuries, anemia or urine crystals.

Cited by 3 publications

References 21 publications

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

A nomogram for predicting the hospital-acquired infections in children with spinal cord injuries: a retrospective, multicenter, observational study

Is It Really the Foley? A Systematic Review of Bladder Management and Infection Risk

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