Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study

Abstract

Study design

Cross-sectional survey of the Neurogenic Bladder Research Group (NBRG) registry; a multicenter prospective observation study.

Objectives

To assess how patient-reported urinary tract infections (PRUTIs) in spinal cord injury (SCI) affect quality of life (QOL).

Setting

Multiple United States hospitals.

Methods

1479 participants with SCI were asked about neurogenic bladder-related QOL. Eligibility: age ≥ 18 years with acquired SCI. PRUTI frequency over the last year was classified as 0, 1–3, 4–6, or >6. Four UTI QOL domains were assessed: (1) UTIs limited daily activities, (2) UTIs caused increased muscle spasms, (3) UTIs would not go away, and (4) UTIs made me avoid going out. Multivariable regression identified variables associated with poor QOL.

Results

PRUTI frequency was 0 in 388 patients (26%), 1–3 in 677 (46%), 4–6 in 223 (15%), and more than 6 in 190 (13%). Increasing PRUTI rate was independently associated with worse QOL for all four questions. Compared with those with 0 PRUTIs, participants reporting >6 were more likely to limit daily activities (OR 9.0 [95% CI 8.1–21.2] p < 0.0001), experience increased muscle spasms (OR 12.4 [95% CI 7.5–20.6] p < 0.0001), perceive a UTI would not go away (OR 30.1 [95% CI 15.0–60.4] p < 0.0001), and avoid going out because of UTIs (OR 7.2 [95% CI 4.2–12.4] p < 0.0001).

Conclusions

An increasing rate of PRUTIs is independently associated with worse QOL. Thorough evaluation and treatment may improve QOL in this population.

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Fig. 1: Increasing PRUTI rate is associated with decreasing QOL in a stepwise fashion.

Data availability

The datasets generate and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge the Patient-Centered Outcomes Research Institute (PCORI) for financial assistance with the development of the data registry on which this project is based. We would also like to thank the Neurogenic Bladder Research Group (NBRG) for their help with, and support of, this project.

Funding

This work was partially supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER14092138). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI.

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KMT helped design the study, played an important role in interpreting the results, drafted, and revised the manuscript. RM helped to revise the manuscript for important intellectual content and approved the final version. JD helped conceive and design the study and approved the final version. JJP helped interpret the results, revise the manuscript, and approved the final version. JTS revised the manuscript for important intellectual content and approved the final version. SML revised the manuscript for important intellectual content and approved the final version. JBM revised the manuscript for important intellectual content and approved the final version. BW revised the manuscript for important intellectual content and approved the final version. SPE conceive and design study, played important role in interpreting the results, revised the manuscript, approved the final version, and agrees to be accountable for all aspects of the work.

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Correspondence to Katherine M. Theisen.

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Theisen, K.M., Mann, R., Roth, J.D. et al. Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-0481-z

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