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

Abstract

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) (

Incidence and risk factors of urinary tract infection in hospitalized patients with spinal cord injury in a hospital of China

“…Additionally, we conducted a stratified analysis based on sex, revealing that males exhibited a prolonged duration of indwelling catheters compared to females across all identified UTI risk factors. A Korean study also suggests that this may be a result of sex being associated with a higher percentage of male patients having indwelling catheters than female patients, instead of a correlation between UTI and sex 15 . There are significant sex-stratified differences in bladder management after SCI, which should be noted by healthcare professionals.…”

Effects of comprehensive functional nursing on functional recovery and quality of life in patients with spinal cord injury

“…Renal failure is the primary cause of late death in patients with SCIs. [41][42][43] Therefore, scientific bladder management and training important for reducing urinary complications and improving the quality of life of patients with SCIs. This study showed that the number of micturition, residual urine volume, and LUTS score in the comprehensive care group were significantly lower than those in the general care group, and maximum urine and bladder volumes in the comprehensive care group were significantly higher than those in the general care group, suggesting that comprehensive functional nursing can promote the recovery of bladder function in patients with SCI.…”

Urinary tract infections and intermittent catheterization among patients with spinal cord injury in Chinese community

“…Since existing studies have exquisitely found that SCI impairs voluntary control of voiding and the normal reflex pathways that coordinate bladder and sphincter function 14 , 15 , proper bladder management is essential for the prevention of urological complications in patients with SCI 13 . Furthermore, several articles have reported that the method of bladder emptying may be a major risk factor for the development of urolithiasis in patients with SCI 16 , 17 . Consequently, with the help of the National Alliance for Spinal Cord Injury Patient Care, we initiated a questionnaire survey on urolithiasis-related issues covering 30 provinces in China, in the hope of understanding the current status of UTIs and bladder management in spinal cord injury patients in the Chinese community, and to find out measures to improve bladder management and reduce UTIs.…”