MP48-07 FREQUENCY OF PATIENT-REPORTED UTIs PREDICTS POOR QUALITY OF LIFE AFTER SPINAL CORD INJURY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP48)1 Apr 2020MP48-07 FREQUENCY OF PATIENT-REPORTED UTIs PREDICTS POOR QUALITY OF LIFE AFTER SPINAL CORD INJURY Katherine Theisen*, Rachel Mann, Joshua Roth, Joseph Pariser, John Stoffel, Sara Lenherr, Jeremy Myers, Blayne Welk, and Sean Elliott Katherine Theisen*Katherine Theisen* More articles by this author , Rachel MannRachel Mann More articles by this author , Joshua RothJoshua Roth More articles by this author , Joseph PariserJoseph Pariser More articles by this author , John StoffelJohn Stoffel More articles by this author , Sara LenherrSara Lenherr More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Blayne WelkBlayne Welk More articles by this author , and Sean ElliottSean Elliott More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000903.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary tract infections (UTIs) are a major source of morbidity after spinal cord injury (SCI). People with SCI attribute a variety of symptoms to UTI; but up to 60% of the time urine culture is inconsistent with a UTI. Unfortunately, negative cultures can lead providers to dismiss the symptoms. We hypothesize that patient-reported symptoms of a UTI have a major impact on quality of life (QOL) and warrant further investigation and amelioration, regardless of urine culture results. METHODS: The Neurogenic Bladder Research Group SCI registry asked 1475 SCI participants about neurogenic bladder-related QOL. Eligibility included age >18 years and acquired SCI. UTI frequency over the past year was by patient report and classified as 0, 1-3, 4-6, or >6. Four UTI QOL questions were administered: 1) UTIs limited daily activities; 2) UTIs caused increased spasms; 3) UTIs would not go away; 4) UTIs caused me to avoid going out. A 5-point Likert scale of responses ranged from “never” to “always”. Multivariable regression was performed to identify independent predictors for poor QOL. This controlled for demographic and clinical variables, including neurogenic bladder symptom score which measures overall bladder function. RESULTS: At enrollment, patient-reported UTI frequency over the prior year was 0 in 388 patients (26%), 1-3 in 677 (46%), 4-6 in 223 (15%), and more than 6 in 190 (13%). All four UTI QOL measures were inversely related to the number of UTIs experienced (p<0.001) (Figure 1). When controlling for confounders, we found that increasing UTI frequency was an independent predictor of worse QOL across all four questions. When comparing patients with >6 UTIs to those with 0, the odds of limiting daily activity, experiencing increased muscle spasms, perceiving a UTI would not go away, and avoiding going out were 9.6 (95% CI 5.8-15.7), 13.7 (95% CI 8.3-22.6), 35.3 (95% CI 17.7-70.5), and 8.1 (95% CI 4.7-13.9), respectively. CONCLUSIONS: The frequency of patient-reported UTIs is independently associated with worse QOL. Even if a urine culture proves to be negative, providers should address the symptoms that led to the evaluation; others causes of these symptoms should be considered and addressed in order to improve the QOL of this population. Source of Funding: Patient Centered Outcomes Research Institute © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e696-e697 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Theisen* More articles by this author Rachel Mann More articles by this author Joshua Roth More articles by this author Joseph Pariser More articles by this author John Stoffel More articles by this author Sara Lenherr More articles by this author Jeremy Myers More articles by this author Blayne Welk More articles by this author Sean Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...