Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization
Objective Clean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC....
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| Veröffentlicht in: | Neurourology and urodynamics 2019-06, Vol.38 (5), p.1332-1338 |
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| creator | Crescenze, Iryna M. Myers, Jeremy B. Lenherr, Sara M. Elliott, Sean P. Welk, Blayne MPH, Diana O'Dell Qin, Yongmei Presson, Angela P. Stoffel, John T. |
| description | Objective
Clean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC.
Methods
Over 1.5 years, 1479 adults with SCI were prospectively enrolled through the Neurogenic Bladder Research Group registry, and 753 on CIC with no prior surgeries were included. Injury characteristics, complications, hand function, and Neurogenic Bladder Symptom Score (NBSS) were analyzed. The NBSS QoL question (overall satisfaction with urinary function) was dichotomized to generate comparative groups (dissatisfied vs neutral/satisfied).
Results
The cohort was 32.9% female with a median age of 43.2 (18‐86) years, time since the injury of 9.8 (0‐48.2) years, and 69.0% had an injury at T1 or below. Overall 36.1% were dissatisfied with urinary QoL. On multivariable analysis, female gender (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.15‐2.31; P = 0.016), earlier injury (OR, 0.95 per year; 95% CI, 0.93‐0.97; P |
| doi_str_mv | 10.1002/nau.23983 |
| format | Article |
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Clean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC.
Methods
Over 1.5 years, 1479 adults with SCI were prospectively enrolled through the Neurogenic Bladder Research Group registry, and 753 on CIC with no prior surgeries were included. Injury characteristics, complications, hand function, and Neurogenic Bladder Symptom Score (NBSS) were analyzed. The NBSS QoL question (overall satisfaction with urinary function) was dichotomized to generate comparative groups (dissatisfied vs neutral/satisfied).
Results
The cohort was 32.9% female with a median age of 43.2 (18‐86) years, time since the injury of 9.8 (0‐48.2) years, and 69.0% had an injury at T1 or below. Overall 36.1% were dissatisfied with urinary QoL. On multivariable analysis, female gender (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.15‐2.31; P = 0.016), earlier injury (OR, 0.95 per year; 95% CI, 0.93‐0.97; P < 0.001), ≥4 urinary tract infections (UTIs) per year (OR, 2.36; 95% CI, 1.47‐3.81; P = 0.001), and severe bowel dysfunction (OR, 1.42; 95% CI, 1.02‐1.98; P = 0.035) predicted dissatisfaction. Level of injury, fine motor hand function, and caregiver dependence for CIC were not associated with dissatisfaction.
Conclusions
In a mature SCI cohort, physical disability does not predict dissatisfaction with urinary QoL but severe bowel dysfunction and recurrent UTIs have a significant negative impact. With time the rates of dissatisfaction decline but women continue to be highly dissatisfied on CIC and may benefit from early intervention to minimize the burden of CIC on urinary QoL.</description><identifier>ISSN: 0733-2467</identifier><identifier>EISSN: 1520-6777</identifier><identifier>DOI: 10.1002/nau.23983</identifier><identifier>PMID: 30912199</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; clean intermittent catheterization ; Cohort Studies ; Female ; Humans ; Intermittent Urethral Catheterization - adverse effects ; Male ; Middle Aged ; neurogenic bladder ; Patient Satisfaction ; patient‐reported outcomes ; Quality of Life ; Sex Factors ; Spinal Cord Injuries - complications ; Spinal Cord Injuries - physiopathology ; spinal cord injury ; Urinary Bladder, Neurogenic - etiology ; Urinary Bladder, Neurogenic - physiopathology ; Urinary Tract Infections - etiology ; Urination - physiology ; Young Adult</subject><ispartof>Neurourology and urodynamics, 2019-06, Vol.38 (5), p.1332-1338</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4263-cf09d50bd02423a6f5d16a9394bc009333649f455d930f89b26cb2cd0bdb06683</citedby><cites>FETCH-LOGICAL-c4263-cf09d50bd02423a6f5d16a9394bc009333649f455d930f89b26cb2cd0bdb06683</cites><orcidid>0000-0001-7093-558X ; 0000-0002-0453-0573</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fnau.23983$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fnau.23983$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30912199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Crescenze, Iryna M.</creatorcontrib><creatorcontrib>Myers, Jeremy B.</creatorcontrib><creatorcontrib>Lenherr, Sara M.</creatorcontrib><creatorcontrib>Elliott, Sean P.</creatorcontrib><creatorcontrib>Welk, Blayne</creatorcontrib><creatorcontrib>MPH, Diana O'Dell</creatorcontrib><creatorcontrib>Qin, Yongmei</creatorcontrib><creatorcontrib>Presson, Angela P.</creatorcontrib><creatorcontrib>Stoffel, John T.</creatorcontrib><creatorcontrib>Neurogenic Bladder Research Group</creatorcontrib><creatorcontrib>for the Neurogenic Bladder Research Group</creatorcontrib><title>Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization</title><title>Neurourology and urodynamics</title><addtitle>Neurourol Urodyn</addtitle><description>Objective
Clean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC.
Methods
Over 1.5 years, 1479 adults with SCI were prospectively enrolled through the Neurogenic Bladder Research Group registry, and 753 on CIC with no prior surgeries were included. Injury characteristics, complications, hand function, and Neurogenic Bladder Symptom Score (NBSS) were analyzed. The NBSS QoL question (overall satisfaction with urinary function) was dichotomized to generate comparative groups (dissatisfied vs neutral/satisfied).
Results
The cohort was 32.9% female with a median age of 43.2 (18‐86) years, time since the injury of 9.8 (0‐48.2) years, and 69.0% had an injury at T1 or below. Overall 36.1% were dissatisfied with urinary QoL. On multivariable analysis, female gender (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.15‐2.31; P = 0.016), earlier injury (OR, 0.95 per year; 95% CI, 0.93‐0.97; P < 0.001), ≥4 urinary tract infections (UTIs) per year (OR, 2.36; 95% CI, 1.47‐3.81; P = 0.001), and severe bowel dysfunction (OR, 1.42; 95% CI, 1.02‐1.98; P = 0.035) predicted dissatisfaction. Level of injury, fine motor hand function, and caregiver dependence for CIC were not associated with dissatisfaction.
Conclusions
In a mature SCI cohort, physical disability does not predict dissatisfaction with urinary QoL but severe bowel dysfunction and recurrent UTIs have a significant negative impact. With time the rates of dissatisfaction decline but women continue to be highly dissatisfied on CIC and may benefit from early intervention to minimize the burden of CIC on urinary QoL.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>clean intermittent catheterization</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Intermittent Urethral Catheterization - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>neurogenic bladder</subject><subject>Patient Satisfaction</subject><subject>patient‐reported outcomes</subject><subject>Quality of Life</subject><subject>Sex Factors</subject><subject>Spinal Cord Injuries - complications</subject><subject>Spinal Cord Injuries - physiopathology</subject><subject>spinal cord injury</subject><subject>Urinary Bladder, Neurogenic - etiology</subject><subject>Urinary Bladder, Neurogenic - physiopathology</subject><subject>Urinary Tract Infections - etiology</subject><subject>Urination - physiology</subject><subject>Young Adult</subject><issn>0733-2467</issn><issn>1520-6777</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQhi0EoqUw8AeQRxjSXmzHiccK8SVVwEDnyHEc4Sp1WttRVX49pilsTKe7e-6V7kHoOoVpCkBmVvZTQkVBT9A4zQgkPM_zUzSGnNKEMJ6P0IX3KwAoKBPnaERBpCQVYozsu9O1UaFzHncNbrsd7p2x0u3xtpetCfvD2DQaG4v9Jq5arDpXx3bVR2ojg9E2xGuLVauljYug3dqEEMdYyfCpY2--ItfZS3TWyNbrq2OdoOXjw8f9c7J4e3q5ny8SxQiniWpA1BlUNRBGqORNVqdcCipYpQAEpZQz0bAsqwWFphAV4aoiqo4XFXBe0Am6HXI3rtv22odybbzSbSut7npfxufzQrA8ZRG9G1DlOu-dbsqNM-sooEyh_NFbRr3lQW9kb46xfbXW9R_56zMCswHYmVbv_08qX-fLIfIbBsOF5g</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Crescenze, Iryna M.</creator><creator>Myers, Jeremy B.</creator><creator>Lenherr, Sara M.</creator><creator>Elliott, Sean P.</creator><creator>Welk, Blayne</creator><creator>MPH, Diana O'Dell</creator><creator>Qin, Yongmei</creator><creator>Presson, Angela P.</creator><creator>Stoffel, John T.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7093-558X</orcidid><orcidid>https://orcid.org/0000-0002-0453-0573</orcidid></search><sort><creationdate>201906</creationdate><title>Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization</title><author>Crescenze, Iryna M. ; Myers, Jeremy B. ; Lenherr, Sara M. ; Elliott, Sean P. ; Welk, Blayne ; MPH, Diana O'Dell ; Qin, Yongmei ; Presson, Angela P. ; Stoffel, John T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4263-cf09d50bd02423a6f5d16a9394bc009333649f455d930f89b26cb2cd0bdb06683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>clean intermittent catheterization</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Intermittent Urethral Catheterization - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>neurogenic bladder</topic><topic>Patient Satisfaction</topic><topic>patient‐reported outcomes</topic><topic>Quality of Life</topic><topic>Sex Factors</topic><topic>Spinal Cord Injuries - complications</topic><topic>Spinal Cord Injuries - physiopathology</topic><topic>spinal cord injury</topic><topic>Urinary Bladder, Neurogenic - etiology</topic><topic>Urinary Bladder, Neurogenic - physiopathology</topic><topic>Urinary Tract Infections - etiology</topic><topic>Urination - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Crescenze, Iryna M.</creatorcontrib><creatorcontrib>Myers, Jeremy B.</creatorcontrib><creatorcontrib>Lenherr, Sara M.</creatorcontrib><creatorcontrib>Elliott, Sean P.</creatorcontrib><creatorcontrib>Welk, Blayne</creatorcontrib><creatorcontrib>MPH, Diana O'Dell</creatorcontrib><creatorcontrib>Qin, Yongmei</creatorcontrib><creatorcontrib>Presson, Angela P.</creatorcontrib><creatorcontrib>Stoffel, John T.</creatorcontrib><creatorcontrib>Neurogenic Bladder Research Group</creatorcontrib><creatorcontrib>for the Neurogenic Bladder Research Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurourology and urodynamics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Crescenze, Iryna M.</au><au>Myers, Jeremy B.</au><au>Lenherr, Sara M.</au><au>Elliott, Sean P.</au><au>Welk, Blayne</au><au>MPH, Diana O'Dell</au><au>Qin, Yongmei</au><au>Presson, Angela P.</au><au>Stoffel, John T.</au><aucorp>Neurogenic Bladder Research Group</aucorp><aucorp>for the Neurogenic Bladder Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization</atitle><jtitle>Neurourology and urodynamics</jtitle><addtitle>Neurourol Urodyn</addtitle><date>2019-06</date><risdate>2019</risdate><volume>38</volume><issue>5</issue><spage>1332</spage><epage>1338</epage><pages>1332-1338</pages><issn>0733-2467</issn><eissn>1520-6777</eissn><abstract>Objective
Clean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC.
Methods
Over 1.5 years, 1479 adults with SCI were prospectively enrolled through the Neurogenic Bladder Research Group registry, and 753 on CIC with no prior surgeries were included. Injury characteristics, complications, hand function, and Neurogenic Bladder Symptom Score (NBSS) were analyzed. The NBSS QoL question (overall satisfaction with urinary function) was dichotomized to generate comparative groups (dissatisfied vs neutral/satisfied).
Results
The cohort was 32.9% female with a median age of 43.2 (18‐86) years, time since the injury of 9.8 (0‐48.2) years, and 69.0% had an injury at T1 or below. Overall 36.1% were dissatisfied with urinary QoL. On multivariable analysis, female gender (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.15‐2.31; P = 0.016), earlier injury (OR, 0.95 per year; 95% CI, 0.93‐0.97; P < 0.001), ≥4 urinary tract infections (UTIs) per year (OR, 2.36; 95% CI, 1.47‐3.81; P = 0.001), and severe bowel dysfunction (OR, 1.42; 95% CI, 1.02‐1.98; P = 0.035) predicted dissatisfaction. Level of injury, fine motor hand function, and caregiver dependence for CIC were not associated with dissatisfaction.
Conclusions
In a mature SCI cohort, physical disability does not predict dissatisfaction with urinary QoL but severe bowel dysfunction and recurrent UTIs have a significant negative impact. With time the rates of dissatisfaction decline but women continue to be highly dissatisfied on CIC and may benefit from early intervention to minimize the burden of CIC on urinary QoL.</abstract><cop>United States</cop><pmid>30912199</pmid><doi>10.1002/nau.23983</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7093-558X</orcidid><orcidid>https://orcid.org/0000-0002-0453-0573</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over clean intermittent catheterization Cohort Studies Female Humans Intermittent Urethral Catheterization - adverse effects Male Middle Aged neurogenic bladder Patient Satisfaction patient‐reported outcomes Quality of Life Sex Factors Spinal Cord Injuries - complications Spinal Cord Injuries - physiopathology spinal cord injury Urinary Bladder, Neurogenic - etiology Urinary Bladder, Neurogenic - physiopathology Urinary Tract Infections - etiology Urination - physiology Young Adult |
| title | Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization |
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