Factors Contributing to Transition of Bladder Management Method Following Traumatic Spinal Cord Injury.

OBJECTIVES

To identify demographic and medical factors associated with changing bladder management method and document the reason for changing bladder management method among adults with spinal cord injury (SCI).

METHODS

This cohort study included 20 Spinal Cord Injury Model Systems (SCIMS) centers. Participants were individuals injured between 1972 and 2019 who completed 2 consecutive assessments of bladder management method within 5 years and identified the reason for changing bladder management method at the second assessment. Main outcome measures were change in bladder management method since first assessment (changed/not changed) and, if change occurred, reason for changing.

RESULTS

Of 10,769 persons included in the analysis, 10.6% reported change in bladder management at the second assessment. After adjusting for covariates, higher odds of changing bladder management was observed among people who completed first assessment at discharge from initial rehabilitation and those who (a) used nonvolitional voiding for bladder management, (b) were older than 44 years of age, (c) had less than high school education, and (d) resided in a hospital or nursing home. The most reported reason for changing bladder management was medical-related factors (48.2%), followed by functional improvement (28.5%) and personal factors (19.6%).

CONCLUSION

Understanding the patterns and predictors of bladder management transitions can help clinicians anticipate potential changes, provide proactive education and support, and implement strategies to minimize secondary complications.