Edward Chia-Cheng Lai1, Yea-Huei Kao Yang, Hann-Chorng Kuo. 1. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan 701, Taiwan.
Abstract
PURPOSE: In view of the limited information on neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI) in the literature, this study aimed to investigate the complication rate of NLUTD after SCI and to describe the clinical management of NLUTD in Taiwan. METHODS: A cross-sectional study was conducted using the National Health Insurance Research Database of Taiwan from which patients newly diagnosed with SCI during 2006-2008 were extracted. Records of diagnosis, prescriptions, and procedures for patients were retrieved to identify NLUTD cases. The utilization of medical treatments including pharmacotherapy and procedures such as intermittent and indwelling catheters was analyzed. RESULTS: A total of 941 eligible SCI patients were identified, with a mean age of 48.4 (±18.5), of which 575 (61.1 %) were male, and 500 (53.1 %) were with cervical SCI. By the end of 1-year follow-up, 165 (17.5 %) had developed NLUTD. The characteristics were mostly similar between the NLUTD and non-NLUTD groups except in age and length of stay (LOS) in hospitals, where patients with NLUTD were 7.5 years old and had 2.15-month-longer LOS. Over 80 % of NLUTD patients received urinary catheterization, with approximately half also receiving pharmacotherapy. CONCLUSIONS: This is the first study using nationwide datasets to evaluate the overall complication rate of NLUTD associated with SCI, which is shown to be lower than previously reported. While various treatment options are available, urinary catheterization is the most common treatment for NLUTD.
PURPOSE: In view of the limited information on neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI) in the literature, this study aimed to investigate the complication rate of NLUTD after SCI and to describe the clinical management of NLUTD in Taiwan. METHODS: A cross-sectional study was conducted using the National Health Insurance Research Database of Taiwan from which patients newly diagnosed with SCI during 2006-2008 were extracted. Records of diagnosis, prescriptions, and procedures for patients were retrieved to identify NLUTD cases. The utilization of medical treatments including pharmacotherapy and procedures such as intermittent and indwelling catheters was analyzed. RESULTS: A total of 941 eligible SCI patients were identified, with a mean age of 48.4 (±18.5), of which 575 (61.1 %) were male, and 500 (53.1 %) were with cervical SCI. By the end of 1-year follow-up, 165 (17.5 %) had developed NLUTD. The characteristics were mostly similar between the NLUTD and non-NLUTD groups except in age and length of stay (LOS) in hospitals, where patients with NLUTD were 7.5 years old and had 2.15-month-longer LOS. Over 80 % of NLUTD patients received urinary catheterization, with approximately half also receiving pharmacotherapy. CONCLUSIONS: This is the first study using nationwide datasets to evaluate the overall complication rate of NLUTD associated with SCI, which is shown to be lower than previously reported. While various treatment options are available, urinary catheterization is the most common treatment for NLUTD.
Authors: C J Fowler; J N Panicker; M Drake; C Harris; S C W Harrison; M Kirby; M Lucas; N Macleod; J Mangnall; A North; B Porter; S Reid; N Russell; K Watkiss; M Wells Journal: Postgrad Med J Date: 2009-10 Impact factor: 2.401