Evaluation of functional outcomes in traumatic spinal cord injury with rehabilitation-acquired urinary tract infections: A retrospective study

Stampas, Argyrios; Dominick, Elizabeth; Zhu, Liang

doi:10.1080/10790268.2018.1452389

Cited by 18 publications

(10 citation statements)

References 22 publications

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“…Urinary tract infections are a common source of morbidity among patients undergoing rehabilitation for spinal cord injuries [23]. Moreover, studies of patients undergoing neurorehabilitation for stroke, brain, and spinal cord disorders have demonstrated that decreased functional scores are associated with urinary tract infections [29][30][31]. In our study, there was no statistical significance in the functional scores between the patients with and without acute urinary dysfunction (see Table 1).…”

Section: Discussioncontrasting

confidence: 54%

Urinary Dysfunction: Frequency, Risk factors, and Interventions in patients with Cancer during Acute Inpatient Rehabilitation

Tennison¹,

Pally²,

Fellman³

et al. 2023

J. Cancer

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Introduction: Urinary dysfunction has a strong impact clinically, socially, and economically. Although the development of acute urinary dysfunction in hospitalized patients with cancer is common in clinical practice, its occurrence and management strategies are scant in the literature. It has been reported as one of the more common medical complications in patients with cancer undergoing acute inpatient rehabilitation. This study assessed the frequency of and risk factors for acute urinary dysfunction among these patients and identified the interventions used for management. Methods: This is a retrospective study of consecutive patients admitted to a National Cancer Institute Comprehensive Cancer Center's acute inpatient rehabilitation service from 9/1/2020 through 3/15/2021. We excluded patients that were readmissions during the study time frame. We collected patients' demographic, clinical, and functional data. We defined acute urinary dysfunction as the development of any new urinary symptom(s) or diagnosis, which involved additional work-up and/or management after admission to the acute inpatient rehabilitation service. Results: Of the 176 total patients included in this study, 47 (27%; 95% confidence interval [CI], 20-34) patients had acute urinary dysfunction. The most frequent diagnoses were urinary tract infection (32%) and neurogenic bladder (26%). The most common tests were urine cultures (32%) and urinalyses (30%). The most commonly prescribed medications were antibiotics (32%) and alpha-1 blockers (15%). Other most frequent interventions included timed voiding (34%) and intermittent catheterization with bladder scans (28%). Acute urinary dysfunction was associated with an increased length of stay on the inpatient rehabilitation service (odds ratio [OR], 1.13; 95% CI, 1.06-1.20; P<.001), surgery during the index admission (OR, 2.50; 95% CI, 1.21-5.16; P=.014), and fecal incontinence (OR, 6.41; 95% CI, P=.004). Conclusion: Acute urinary dysfunction was noted to be a substantial problem in this cohort. This is an overlooked dimension of inpatient cancer rehabilitation that deserves more attention. Patients at risk for acute urinary dysfunction may benefit from close monitoring for medical management and rehabilitation interventions to maximize functional independence with bladder care. More research regarding acute urinary dysfunction types and management approaches in post-acute care settings for patients with cancer is justified.

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Section: Discussioncontrasting

confidence: 54%

Urinary Dysfunction: Frequency, Risk factors, and Interventions in patients with Cancer during Acute Inpatient Rehabilitation

Tennison¹,

Pally²,

Fellman³

et al. 2023

J. Cancer

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show abstract

“…Interestingly, a study from the United State found a statistically significant correlation between acquired UTIs and lower Functional Independence Measure motor scores on admission, gain, and discharge in traumatic SCI rehabilitation. 31 Independence in performing activities depends not only on SCI's level and severity but also on early access to an inpatient postacute SCI rehabilitation program by SCI specialized rehabilitation teams. 32 A recent study in Thailand confirmed that admission for inpatient postacute rehabilitation to an SCI specialized rehabilitation facility is a predictive factor of better outcomes.…”

Section: Discussionmentioning

confidence: 99%

Impacts of Bladder Managements and Urinary Complications on Quality of Life

Pattanakuhar

Ahmedy

Setiono

et al. 2022

Am J Phys Med Rehabil

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Background: The impact of bladder care and urinary complications on quality of life in persons with spinal cord injury who have neurogenic lower urinary tract dysfunction has not been elucidated, especially in those living in low-resource countries. Methods: This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Communitydwelling adults with traumatic or nontraumatic spinal cord injury participating in the International Spinal Cord Injury Community Survey from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection, and quality of life score were extracted from the International Spinal Cord Injury Community Survey questionnaire. The impact of bladder care and urinary complications on quality of life was determined using univariable and multivariable regression analysis. Results: Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and spinal cord injury-related data, secondary conditions, as well as activity and participation factors, urinary tract infection was an independent negative predictive factor of quality of life score (P = 0.007, unstandardized coefficients = −4.563, multivariable linear regression analysis, enter method). Conclusions: Among bladder care and urinary complication factors, urinary tract infection is the only factor negatively impacting quality of life. These results address the importance of proper bladder management and urinary tract infection prevention in persons with spinal cord injury to improve their quality of life.

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“…The FIM consists of 18 scored items divided into motor and cognitive subscales 9 . Administration of the FIM at admission may vary by facility 10 . Following hospital protocol, the minimal score on total FIM is 18 (total assistance), and the maximum score is 126 (complete independence) 9 .…”

Section: Methodsmentioning

confidence: 99%

“…9 Administration of the FIM at admission may vary by facility. 10 Following hospital protocol, the minimal score on total FIM is 18 (total assistance), and the maximum score is 126 (complete independence). 9 Although minimal clinically important difference (MCID) has not been established for SCI, in an acute stroke population, MCID is 22 points for total FIM, 17 points for FIM motor subscale, and 3 points for cognitive subscale.…”

Section: Outcome Measurementioning

confidence: 99%

Effects of Dynamic Overground Body Weight Support Training During Inpatient Rehabilitation After Traumatic Spinal Cord Injury

Powell

Lopez²,

Westgate³

et al. 2021

Am J Phys Med Rehabil

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Rehabilitation strategies after traumatic spinal cord injury aim to maximize functional recovery by applying principles of neuroplasticity via task-specific, repetitive training. Rehabilitation of patients with traumatic spinal cord injury poses unique challenges, including bilateral limb involvement, autonomic dysfunction, loss of proprioception, and potentially spinal precautions/bracing. The purpose of this retrospective case series was to determine whether use of dynamic body weight support would yield greater improvement in functional recovery compared with standard of care in adults with traumatic spinal cord injury. Data were collected from patients with traumatic spinal cord injury who completed inpatient rehabilitation incorporating dynamic body weight support (n = 5) and who completed inpatient rehabilitation without dynamic body weight support (n = 5). The primary outcome measure was the change in Functional Independence Measures. The dynamic body weight support group had a significantly greater improvement in Total Functional Independence Measures and in Functional Independence Measures motor subscale compared with the standard of care group (P = 0.023 and P = 0.033, respectively). This study presents initial evidence that dynamic body weight support therapy during inpatient rehabilitation has the potential to improve functional independence compared with standard of care in patients with traumatic spinal cord injury. Larger prospective randomized studies need to be conducted to expand on these findings.

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Evaluation of functional outcomes in traumatic spinal cord injury with rehabilitation-acquired urinary tract infections: A retrospective study

Cited by 18 publications

References 22 publications

Urinary Dysfunction: Frequency, Risk factors, and Interventions in patients with Cancer during Acute Inpatient Rehabilitation

Urinary Dysfunction: Frequency, Risk factors, and Interventions in patients with Cancer during Acute Inpatient Rehabilitation

Impacts of Bladder Managements and Urinary Complications on Quality of Life

Effects of Dynamic Overground Body Weight Support Training During Inpatient Rehabilitation After Traumatic Spinal Cord Injury

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