Risk and Protective Factors for Cause-Specific Mortality After Spinal Cord Injury

Krause, James S.; Cao, Yue; DeVivo, Michael J.; DiPiro, Nicole D.

doi:10.1016/j.apmr.2016.07.001

Cited by 61 publications

(39 citation statements)

References 39 publications

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“…None of the other dogs euthanized or died due to pyelonephritis or septicemia. This is in contrast to the fact that UTI is one the major causes of septicemia in paralyzed people 14,15 and although the rates of UTI-related deaths have significantly decreased during the past decades, 2 it still serves as one of the more important causes of death in people with chronic SCI (9%). 15 The number of dogs for which we had survival data was limited to 35, and only 8 of these dogs were deceased and so the lack of significance may simply reflect the small amount of data.…”

Section: Discussionmentioning

confidence: 94%

“…Appropriate diagnosis and treatment of these infections are important as they increase the risk of pyelonephritis, negatively impact quality of life, and interfere with rehabilitation . Furthermore, UTI is an important cause of septicemia, one of the major contributors to increased mortality in spinal cord‐injured patients . However, this clinical picture is complicated by the frequency of asymptomatic bacteriuria.…”

mentioning

confidence: 99%

“…[1][2][3]8 Furthermore, UTI is an important cause of septicemia, one of the major contributors to increased mortality in spinal cord-injured patients. 5,8,[13][14][15] However, this clinical picture is complicated by the frequency of asymptomatic bacteriuria. This is considered a common finding among people with SCI and is not an indication for antimicrobial treatment because it could give rise to antibiotic-resistant infections.…”

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confidence: 99%

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The Frequency and Clinical Implications of Bacteriuria in Chronically Paralyzed Dogs

Baigi

Vaden

Olby

2017

Veterinary Internal Medicne

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BackgroundParalysis is a known risk factor for urinary tract infections (UTI), sepsis, and death in paralyzed people, but there are no data available on diagnostic criteria for UTI versus bacteriuria, their frequency, or clinical implications in chronically paralyzed dogs.Hypothesis/ObjectivesThat chronically paralyzed dogs suffer frequent bacteriuria causing reduced duration of survival. We documented the frequency of bacteriuria, associated clinical signs, and survival rate in chronically paralyzed dogs.AnimalsForty‐seven client‐owned dogs paralyzed with no pelvic limb pain perception for >3 months and at least one urine culture (UC) performed.MethodsRetrospective, observational study. Medical records of dogs meeting inclusion criteria were reviewed for results of UC, urinalysis, and clinical signs. Outcome was compared between dogs with and without bacteriuria.ResultsThirty‐five of 47 dogs had at least 1 positive UC, and 13 had recurrent bacteriuria. Rectal temperature and urinalysis results were extracted from records. Fever was present at time of UC in 5 of 68 observations, 2 with and 3 without bacteriuria. Pyuria was significantly associated with positive cultures (P < 0.001), cloudiness was not (P = 0.076). Survival data in 35 dogs (8 dead) showed no association between bacteriuria and survival (P = 0.69).Conclusions and Clinical ImportanceBacteriuria is common in paralyzed dogs but does not cause fever; diagnostic criteria of UTI are unclear. We did not detect an association of bacteriuria with survival, but this needs further confirmation.

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Section: Discussionmentioning

confidence: 94%

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confidence: 99%

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confidence: 99%

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The Frequency and Clinical Implications of Bacteriuria in Chronically Paralyzed Dogs

Baigi

Vaden

Olby

2017

Veterinary Internal Medicne

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“…Nevertheless, IC can cause bladder atrophy due to long-term poor contraction. Filth accumulated in the folds of the bladder wall can also lead to cystitis, bladder stones, smaller capacities, low-compliance bladder, low blood flow to the bladder wall, infections, and high mortality [4][5][6]. The odor and unpleasant appearance of urinal collection bags also arouse the feelings of inferiority and isolation.…”

Section: Introductionmentioning

confidence: 99%

Development of an Assistant System of Clean Intermittent Catheterization for Neurogenic Bladder Dysfunction Patients

et al. 2019

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Clean intermittent catheterization (CIC) is one of the methods currently used to prevent overdistention of the bladder in patients with neurogenic bladder dysfunction (NBD). It is also helpful in preventing urinary tract infection and retaining the function of the bladder. Voiding diary and social behavior are necessary for the patients to maintain their physical and mental health, nevertheless there are currently no good assistant systems to help them achieve these goals. In this study, we propose a CIC assistant system with the functions of recording and tracking the voided volume and accessible lavatory. The aim of this study is to assess the effects from the 12 patients who joined the proposed system. Information collected from participants included their demographics, past medicals, injury characteristics, current and past bladder managements, and any NBD related complications. The results indicate that most patients felt relieved that they could know the voided volume and track their history easily. Moreover, the accessible lavatory function of the proposed system could reduce time consumption by 43.1% in finding the suitable lavatory, thus the desire and willingness of patients to travel increased from 25% to 75% after using the system. The proposed system could help doctors with clinical diagnoses, and help patients to understand more about the history of their catheterization volume and time period. This study provided essential information and design for future investigation.

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“…Previous studies using CoD information have used the underlying CoD for analyses, which is defined as the disease or injury that initiated events leading to death, including chronic conditions [11]. A hierarchical approach was used to identify the CoD relevant for causespecific mortality analyses and the calculation of SMRs, as implemented in previous studies [12]. This approach skips over CoDs related to an external injury code (e.g., sequelae from traffic accident) or SCI-related ICD code to identify a CoD relevant for secondary prevention.…”

Section: Causes Of Deathmentioning

confidence: 99%

Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study

et al. 2019

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Background: Traumatic spinal cord injuries (TSCI) are a neurological condition associated with reduced well-being, increased morbidity and reductions in life expectancy. Estimates of all-cause and cause-specific mortality can aid in identifying targets for prevention and management of contributors for premature mortality. Objectives: To compare all-cause and cause-specific rates of mortality to that of the Swiss general population; to identify differentials in risk of cause-specific mortality according to lesion characteristics. Methods: All-cause and cause-specific standardized mortality ratios (SMRs) were calculated using data from the Swiss Spinal Cord Injury cohort study. Cause-specific subhazard ratios were estimated within a competing risk framework using flexible parametric survival models. Results: Between 1990 and 2011, 2,492 persons sustained a TSCI, of which 379 died. Persons with TSCI had a mortality rate more than 2 times higher than that of the Swiss general population (SMR 2.32; 95% CI 2.10–2.56). Tetraplegic lesions were associated with an increased risk of mortality due to respiratory and cardiovascular diseases, infections, and accidents. Cause-specific SMRs were notably elevated for SCI-related conditions such as urinary tract infections (UTIs) and septicemia. Conclusions: Elevated SMRs due to cardiovascular disease, UTIs and septicemia-related mortality suggest the need for innovation when managing associated secondary health conditions.

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Risk and Protective Factors for Cause-Specific Mortality After Spinal Cord Injury

Cited by 61 publications

References 39 publications

The Frequency and Clinical Implications of Bacteriuria in Chronically Paralyzed Dogs

The Frequency and Clinical Implications of Bacteriuria in Chronically Paralyzed Dogs

Development of an Assistant System of Clean Intermittent Catheterization for Neurogenic Bladder Dysfunction Patients

Comparison of All-Cause and Cause-Specific Mortality of Persons with Traumatic Spinal Cord Injuries to the General Swiss Population: Results from a National Cohort Study

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