Article

OBJECTIVES: To determine the relationships between bladder management method and
medical complications (renal calculi or decubitus ulcers), number of hospital
days, and psychosocial factors. We hypothesized that indwelling catheterization
would be associated with more complications, more hospitalizations, and worse
psychosocial outcomes compared with other bladder management methods.
DESIGN: Inception cohort study. SETTING: Model spinal cord injury (SCI) centers funded by
the National Institute on Disability and Rehabilitation Research from 1973 to
2005. PARTICIPANTS: Persons with new traumatic SCI (N=24,762) enrolled in the
National SCI Database entire data set forms I and II. Patients were stratified
according to the bladder management method recorded at each time of data
collection into 1 of 4 groups as follows: indwelling catheterization, spontaneous
voiding, condom catheterization, and intermittent catheterization. Those who
reported no management method or errors in reporting were excluded (n=1564).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Medical complications,
including pressure ulcer number and grade of worst ulcer, kidney stones, and
hospitalizations, as well as psychosocial factors (satisfaction with life,
perceived health status, societal participation), were stratified by bladder
management method. Results were adjusted for level and completeness of neurologic
injury and other confounding and modifying factors. RESULTS: Compared with other
forms of bladder management, use of an indwelling catheter was associated with
more pressure ulcers and longer and more hospitalizations for all causes and
urology-specific causes. Indwelling catheter use was associated with the lowest
levels of participation, but similar satisfaction with life and perceived health status. CONCLUSIONS: Indwelling catheterization was associated with more medical
complications and lower levels of participation than other bladder management
methods, but more research is required to ascertain the causality of these
complications.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS