Genitourinary Complications Are a Leading and Expensive Cause of Emergency Department and Inpatient Encounters for Persons With Spinal Cord Injury

Arch Phys Med Rehabil, 2019 · DOI: 10.1016/j.apmr.2019.02.013 · Published: September 1, 2019

Simple Explanation

This research investigates the occurrence and costs associated with genitourinary (GU) problems in individuals with spinal cord injuries (SCI) across the United States. Using a large national database, the study examines emergency department visits and hospitalizations related to GU complications after SCI. The findings highlight the significant economic burden and the increasing rates of GU complications, emphasizing the need for better healthcare strategies for this population.

Study Duration

10 Years

Participants

Inpatient sample: 1,796,624 hospitalizations; ED sample: 618,118 treat-and-release visits, SCI patients

Evidence Level

Retrospective cross-sectional study

Key Findings

1
There was a 2.5% annual increase in SCI-related hospitalizations with GU complications from 2006 to 2011, followed by a 0.9% increase from 2011 to 2015.
2
Age, level of injury (cervical injuries or quadriplegia), and payer source (uninsured/underinsured) were significantly correlated with in-hospital mortality.
3
The direct medical costs associated with GU-related health care use for persons with SCI exceeded $4 billion over the study period.

Research Summary

This study analyzed national data to determine the rates and economic burden of genitourinary (GU) complications among individuals with spinal cord injury (SCI) in the United States. The study found increasing rates of GU complications, particularly urinary tract infections, as a primary reason for emergency department visits and hospitalizations among people with SCI. The high costs associated with these complications underscore the need for targeted interventions to improve healthcare delivery and reduce the economic impact.

Practical Implications

Improved Prevention Strategies

Develop and implement targeted interventions to prevent GU infections and complications in individuals with SCI.

Enhanced Diagnostic Accuracy

Improve the diagnostic accuracy of UTIs in SCI patients to reduce unnecessary antibiotic use and prevent catheter-associated UTIs.

Cost-Effective Healthcare Delivery

Implement SCI-specific best practices to reduce healthcare costs associated with GU complications and improve the quality of care.

Study Limitations

1
Accuracy of coding in administrative databases cannot be confirmed.
2
More detailed information on the level of injury was unavailable, leading to heterogeneous neurogenic level of injury groups.
3
The cross-sectional nature of the data limits the ability to investigate readmissions and long-term outcomes.

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