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Neves Videira LG, Corbo LN, de Avila MAG, Martins GP, Schoeller SD, Kappler C, Faleiros F. Analysis of Urinary Incontinence in the Neurogenic Bladder and Its Relationship with the Satisfaction and Lifestyle of People with SCI. Healthcare (Basel) 2024; 12:1501. [PMID: 39120204 PMCID: PMC11311287 DOI: 10.3390/healthcare12151501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, which is possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, and cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence had a negative impact on satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.
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Affiliation(s)
- Lorena Gomes Neves Videira
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, Brazil; (L.G.N.V.); (L.N.C.); (G.P.M.)
| | - Letícia Noelle Corbo
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, Brazil; (L.G.N.V.); (L.N.C.); (G.P.M.)
| | | | - Giovana Pelosi Martins
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, Brazil; (L.G.N.V.); (L.N.C.); (G.P.M.)
| | | | - Christoph Kappler
- Faculty of Rehabilitation Sciences, University of Dortmund, 44227 Dortmund, Germany;
| | - Fabiana Faleiros
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, Brazil; (L.G.N.V.); (L.N.C.); (G.P.M.)
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Wu X, Xi X, Xu M, Gao M, Liang Y, Sun M, Hu X, Mao L, Liu X, Zhao C, Sun X, Yuan H. Prediction of early bladder outcomes after spinal cord injury: The HALT score. CNS Neurosci Ther 2024; 30:e14628. [PMID: 38421138 PMCID: PMC10850821 DOI: 10.1111/cns.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
AIMS Neurogenic bladder (NB) is a prevalent and debilitating consequence of spinal cord injury (SCI). Indeed, the accurate prognostication of early bladder outcomes is crucial for patient counseling, rehabilitation goal setting, and personalized intervention planning. METHODS A retrospective exploratory analysis was conducted on a cohort of consecutive SCI patients admitted to a rehabilitation facility in China from May 2016 to December 2022. Demographic, clinical, and electrophysiological data were collected within 40 days post-SCI, with bladder outcomes assessed at 3 months following SCI onset. RESULTS The present study enrolled 202 SCI patients with a mean age of 40.3 ± 12.3 years. At 3 months post-SCI, 79 participants exhibited complete bladder emptying. Least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analyses identified the H-reflex of the soleus muscle, the American Spinal Injury Association Lower Extremity Motor Score (ASIA-LEMS), and the time from lesion to rehabilitation facility (TLRF) as significant independent predictors for bladder emptying. A scoring system named HALT was developed, yielding a strong discriminatory performance with an area under the receiver operating characteristics curve (aROC) of 0.878 (95% CI: 0.823-0.933). A simplified model utilizing only the H-reflex exhibited excellent discriminatory ability with an aROC of 0.824 (95% CI: 0.766-0.881). Both models demonstrated good calibration via the Hosmer-Lemeshow test and favorable clinical net benefits through decision curve analysis (DCA). In comparison to ASIA-LEMS, both the HALT score and H-reflex showed superior predictive accuracy for bladder outcome. Notably, in individuals with incomplete injuries, the HALT score (aROC = 0.973, 95% CI: 0.940-1.000) and the H-reflex (aROC = 0.888, 95% CI: 0.807-0.970) displayed enhanced performance. CONCLUSION Two reliable models, the HALT score and the H-reflex, were developed to predict bladder outcomes as early as 3 months after SCI onset. Importantly, this study provides hitherto undocumented evidence regarding the predictive significance of the soleus H-reflex in relation to bladder outcomes in SCI patients.
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Affiliation(s)
- Xiangbo Wu
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Xiao Xi
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Mulan Xu
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
- Department of Rehabilitation Medicine, Shenshan Medical Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityShanweiGuangdongChina
| | - Ming Gao
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Ying Liang
- Department of Health StatisticsAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Miaoqiao Sun
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Xu Hu
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Li Mao
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Xingkai Liu
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Chenguang Zhao
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Xiaolong Sun
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
| | - Hua Yuan
- Department of Rehabilitation Medicine, Xijing HospitalAir Force Medical University (Fourth Military Medical University)Xi'anChina
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Zhang Y, Chen Y, Niu M, Li Y, Zhang J, Zhang L, Wu F, Chen Q, Yu H, Tian J. Establishing a core outcome set for neurogenic bladder trials: study protocol for a scoping review and Delphi surveys. Trials 2022; 23:485. [PMID: 35698096 PMCID: PMC9195205 DOI: 10.1186/s13063-022-06419-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Neurogenic bladder (NGB) is a chronic and disabling condition with a high prevalence rate, which can cause economic burden on patients and their families and reduce the quality of life of patients. Researchers have carried out a large number of clinical trials on the effectiveness and safety of different interventions for the treatment of NGB. The published clinical trials of NGB generally suffered from inconsistent and irregular reporting of outcome indicators. To facilitate future research studies of NGB, a core outcome set (COS) is required, which helps translate the results into high-quality evidence. Methods and analysis This mixed-method project has four phases instrument: in phase 1, a scoping review of the literature to identify outcomes that have been reported in clinical trials and systematic reviews of clinical trials of interventions for NGB; in phase 2, a qualitative component using interviews to obtain the views of NGB patients, families, and their caregivers; in phase 3, Delphi survey among stakeholders to prioritize the core outcomes; and in phase 4, a face-to-face consensus meeting to discuss and agree on the final NBG COS. Conclusions We will develop a COS that should be reported in future clinical trials of NGB. Trial registration Core Outcome Measures in Effectiveness Trials (COMET) Initiative database registration: http://www.comet-initiative.org/studies/details/1985. Registered on 02 January 2022. INPLASY INPLASY202210007
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Affiliation(s)
- Yan Zhang
- Department of Spinal Cord Injury Rehabilitation, Gansu Province Hospital Rehabilitation Center, 53 Dingxi Road, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Yamin Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Mingming Niu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Yuanyuan Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Jiaoyan Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Li Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China.,The Third Ward of Cardiovascular Clinical Medical Center, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730000, China
| | - Fangfang Wu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China.,School of Nursing, Shangluo Vocational and Technical College, City, Shangluo, 726000, China
| | - Qingyun Chen
- Department of Clinical Laboratory, The Sixth People's Hospital of Chengdu City, Chengdu, 610000, Sichuan, China
| | - Huijin Yu
- Department of Spinal Cord Injury Rehabilitation, Gansu Province Hospital Rehabilitation Center, 53 Dingxi Road, Chengguan District, Lanzhou, 730000, Gansu, China.
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China. .,School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China. .,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, Gansu, China.
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