Characterize patient-reported signs and symptoms of urinary tract infections (UTI) in patients with neurogenic bladder (NB) to inform development of an intervention to improve the accuracy of UTI diagnosis.
Retrospective cohort study, of adults with NB due to spinal cord injury/disorder (SCI/D), multiple sclerosis (MS), and/or Parkinson's Disease (PD) and UTI encounters at four medical centers between 2017-2018. Data were collected through medical record review and analyzed using descriptive statistics and unadjusted logistic regression.
Of 199 patients with NB and UTIs, 37% were diagnosed with MS, 36% SCI/D, and 27% PD. Most patients were men (88%) in inpatient or long-term care settings (60%) with bladder catheters (67%). Fever was the most frequent symptom (32%). Only 38% of patients had a urinary tract-specific symptom; 48% had only non-specific to the urinary tract symptoms. Inpatient encounter setting [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.2-5.2] was associated with greater odds of only having non-specific urinary tract symptoms.
In patients with NB and UTI encounters, non-specific signs and symptoms are most frequently reported. These results can inform interventions to help providers better elicit and document urinary tract specific symptoms in patients with NB presenting with possible UTI, particularly among hospitalized patients.
American journal of physical medicine & rehabilitation. 2023 Mar 15 [Epub ahead of print]
Marissa Wirth, Katie J Suda, Stephen P Burns, Frances M Weaver, Eileen Collins, Nasia Safdar, Rebecca Kartje, Charlesnika T Evans, Margaret A Fitzpatrick
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA., University of Illinois at Chicago College of Nursing, Chicago, IL, USA.