Global & regional health technology assessment · 2025
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СтатьяНазвание и аннотация: Перевод в очереди
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Rumi Filippo, Fortunato Agostino, Di Brino Eugenio, Basile Michele, Antonini Debora, De Palma Luisa, Del Popolo Giulio, Collaborators (in alphabetical order)
Аннотация
INTRODUCTION:: Urinary tract infections (UTIs) are common complications in patients with spinal cord injuries (SCI) and multiple sclerosis (MS), especially those using intermittent catheterization (IC) for neurogenic bladder management. These infections impact quality of life and place a burden on healthcare systems. This study aimed to provide a preliminary estimate of the burden and management of UTIs in SCI and MS patients across Italian healthcare settings.
METHODS:: A structured survey, developed and validated by an expert panel, was distributed to clinicians from various Italian centers. It collected information on diagnostic and therapeutic approaches, risk perception, and prevention strategies for UTIs in tetraplegic/paraplegic SCI and MS patients. The economic impact was estimated using the ABC methodology, considering resource utilization, antibiotic use, diagnostic tests, and management of adverse events.
RESULTS:: Survey data revealed a variability across centers. UTIs affected 75.0% of tetraplegic and 67.5% of paraplegic patients during post-trauma hospitalization, and 45.7% of MS patients. Mean hospital stay was longer for tetraplegic (137.3 days) than paraplegic patients (99.1 days). First-line antibiotic choices differed widely, and second-line treatments were required in 47.1% of SCI and 28.4% of MS cases. The estimated mean cost of UTI management was € 1,141.59 for tetraplegic, € 979.85 for paraplegic, and € 850.37 for MS patients.
CONCLUSION:: This study offers an initial overview of the clinical and economic burden of UTIs in SCI and MS patients in Italy, revealing significant heterogeneity in management. Limitations include the small sample size and the reliance on clinicians’ perceptions rather than real-world data.
METHODS:: A structured survey, developed and validated by an expert panel, was distributed to clinicians from various Italian centers. It collected information on diagnostic and therapeutic approaches, risk perception, and prevention strategies for UTIs in tetraplegic/paraplegic SCI and MS patients. The economic impact was estimated using the ABC methodology, considering resource utilization, antibiotic use, diagnostic tests, and management of adverse events.
RESULTS:: Survey data revealed a variability across centers. UTIs affected 75.0% of tetraplegic and 67.5% of paraplegic patients during post-trauma hospitalization, and 45.7% of MS patients. Mean hospital stay was longer for tetraplegic (137.3 days) than paraplegic patients (99.1 days). First-line antibiotic choices differed widely, and second-line treatments were required in 47.1% of SCI and 28.4% of MS cases. The estimated mean cost of UTI management was € 1,141.59 for tetraplegic, € 979.85 for paraplegic, and € 850.37 for MS patients.
CONCLUSION:: This study offers an initial overview of the clinical and economic burden of UTIs in SCI and MS patients in Italy, revealing significant heterogeneity in management. Limitations include the small sample size and the reliance on clinicians’ perceptions rather than real-world data.