Prediction of severe neurogenic bowel dysfunction in persons with spinal cord injury

Abstract

Study design: Cross-sectional study. Objective: To analyze the predictors of severe neurogenic bowel dysfunction (NBD) in persons with spinal cord injury (SCI). Setting: The Kaohsiung Medical University Hospital, Taiwan. Methods: Two questionnairesFthe NBD score and the Beck Depression Inventory second editionFwere sent to 232 persons with SCI by mail. The demographic factors and injury-related factors were recorded to evaluate any relationships with severe NBD. The associations between the severity of NBD and psychological condition were also measured. Results: In all, 39.4% of the respondents suffered from severe NBD. Multiple logistic regression analysis showed that those with a cervical injury (odds ratios (OR) ¼ 10.5, 95% confidence interval (CI) 1.6-67.7) or a thoracic injury (OR ¼ 7.1, 95% CI 1.2-40.3) had a higher risk of severe NBD than those with a lumbar injury. Persons with American Spinal Injury Association (ASIA) A had a 12.8-fold higher risk of severe NBD than persons with ASIA D (OR ¼ 12.8, 95% CI 3.3-50.1). Longer duration of injury (X10 years) was another risk factor of severe NBD. Moderate-to-severe depression was associated with reduced bowel function. Conclusions: This study showed that high level of cord lesion, completeness of cord injury and longer duration of injury (X10 years) could predict the severity of NBD in patients with SCI.

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

“…This model hypothesizes that both disability factors, such as the presence of impairment or significant restrictions in activity or participation, as well as age-related factors (such as chronological age, age at disability onset, disability inception era and duration of disability), can have direct effects on the development and trajectory of SHCs. The model also hypothesizes that disability and age-related variables can influence the effects of 38,39 Chronic pain 40 Constipation 41 Contractures 27 Deep vein thrombosis/pulmonary embolism 42 Depression 42 Fractures 27 Heterotopic ossification 43 Imobilization hypercalcemia 44 Insomnia/sleep difficulties 37 Kidney stones 18,27 Neurogenic bladder 45 Neurogenic bowel 46 Non-urinary tract infections 27 Obesity 29 Osteoporosis/Bone density loss 15,17,29 Pressure sores 18,41 Restrictive lung disease 47 Septicemia 41 Sexual dysfunction 48,49 Sleep apnea 50 …”

Acute effect of electrical stimulation of the dorsal genital nerve on rectal capacity in patients with spinal cord injury

“…The severity of neurogenic bowel dysfunction mainly depends on the completeness and level of injury, but time since injury is important too. 2,3 Most authors have found that rectal compliance is reduced in patients with supraconal SCI and data suggest that it is increased in those with conal or cauda equina lesions. 4,5 One group has found increased rectal compliance in patients with conal or cauda equina lesions.…”

Self-care practice for bowel functioning in a group of patients with spinal cord injury

“…1,3,5,12,13 In a study made with SCI victims in the city of Maringá, PR, authors identified that before the injury, most of the victims (81.3%) had worked regularly and contributed to the family income, and afterwards, only four individuals (12.5%) worked (as artisans, street vendors, or volunteers), and two (6.3%) studied.…”