Neurourology and urodynamics · 2017
Predictors of long-term bladder management in spinal cord injury patients-Upper extremity function may matter most.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zlatev Dimitar V, Shem Kazuko, Elliott Christopher S
Аннотация
INTRODUCTION: Clean intermittent catheterization (CIC) is the gold standard for neurogenic bladder management in most patients with spinal cord injury (SCI). There is nonetheless a lack of long-term adherence to CIC, with up to 50% discontinuance at 5-year follow-up. We hypothesize that limitations in upper extremity (UE) motor function represent a strong predictor for long-term CIC adoption.
METHODS: We assessed Forms I and II data from the 2000-2013 National SCI Database. Bladder management was determined at initial discharge and 1-year follow-up. Upper extremity (UE) motor scores were transformed using a previously published algorithm to predict a patient's ability to independently self-catheterize. Uni- and multivariable logistic regression modeling was performed to assess risk factors affecting: a) a lack of CIC adoption at rehabilitation discharge, b) CIC discontinuance by 1-year follow-up (CIC "dropout"), and c) adherence to management with an indwelling catheter rather than conversion to CIC at 1-year follow-up.
RESULTS: For all three modeled scenarios, UE motor function represented the most significant predictor for lack of CIC adoption (OR range 2.1-6.3, P ≤ 0.003 for all). Other predictors included increasing age (OR 1.01-1.02, P ≤ 0.001 for all models) and female gender (OR 1.6-1.7, P < 0.001 for lack of CIC adoption at discharge).
CONCLUSIONS: Among physically limiting factors, impairment in UE motor function appears to be the most significant predictor of a lack of long-term CIC adoption at 1-year follow-up.
METHODS: We assessed Forms I and II data from the 2000-2013 National SCI Database. Bladder management was determined at initial discharge and 1-year follow-up. Upper extremity (UE) motor scores were transformed using a previously published algorithm to predict a patient's ability to independently self-catheterize. Uni- and multivariable logistic regression modeling was performed to assess risk factors affecting: a) a lack of CIC adoption at rehabilitation discharge, b) CIC discontinuance by 1-year follow-up (CIC "dropout"), and c) adherence to management with an indwelling catheter rather than conversion to CIC at 1-year follow-up.
RESULTS: For all three modeled scenarios, UE motor function represented the most significant predictor for lack of CIC adoption (OR range 2.1-6.3, P ≤ 0.003 for all). Other predictors included increasing age (OR 1.01-1.02, P ≤ 0.001 for all models) and female gender (OR 1.6-1.7, P < 0.001 for lack of CIC adoption at discharge).
CONCLUSIONS: Among physically limiting factors, impairment in UE motor function appears to be the most significant predictor of a lack of long-term CIC adoption at 1-year follow-up.