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Changes in bladder emptying during inpatient rehabilitation after spinal cord injury and predicting factors: data from the Dutch Spinal Cord Injury Database

Spinal Cord volume 61, pages 624–631 (2023)Cite this article

Subjects

Abstract

Study design

Secondary analysis of multicentre prospective observational data.

Objectives

To describe methods of bladder emptying at admission and discharge in patients with recently acquired spinal cord injury (SCI) and to describe predictors of bladder emptying methods at discharge.

Setting

First inpatient rehabilitation in specialised rehabilitation centres in the Netherlands.

Methods

Data from the Dutch Spinal Cord Injury Database collected between 2015 and 2019 were used. McNemar-Bowker test was used to evaluate if bladder emptying methods differed over time; One-Way ANOVA and Chi-Square tests to see if bladder emptying methods differed by demographic and injury-related characteristics. Binary logistic regression was used to predict the type of bladder emptying at discharge with demographic and injury-related characteristics measured at admission.

Results

Of 1403 patients, 44.1% had cervical, 38.4% thoracic and 17.5% lumbosacral lesions at admission. AIS classification was mostly D (63.8%). The method of bladder emptying changed significantly (p < 0.001) from admission to discharge: decrease of clean intermittent assisted catheterisation (17.1% to 4.1%) and indwelling catheter (33.4% to 16.3%) and increase in clean intermittent self-catheterisation (CISC, 7.8% to 22.2%) and normal voiding (40.2% to 56.1%). Age, sex, SCI level, AIS classification and level of independence predicted the method of bladder emptying at discharge (all p < 0.001).

Conclusions

During first inpatient rehabilitation, the method of bladder emptying changed resulting in more patients discharged with normal voiding and CISC. Age, sex, SCI level, AIS classification and level of independence in self-care were all confirmed as factors playing a role in this change.

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Data availability

The data analysed for this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

The Dutch Spinal Cord Injury Database (DSCID) is a collaboration of the Dutch-Flemish Spinal Cord Society (DuFSCOS), including Adelante: J. Hermans, C.C.M. van Laake-Geelen; Rehabilitation Centre De Hoogstraat: C.A. Dijkstra, J.M. Stolwijk-Swüste; Rehabilitation Centre Heliomare: W.X.M. Faber, D. Gobets; Rehabilitation Centre Het Roessingh: N. Jacobs, E.M. Maas, J. Snijders-Schuttevaar; Rehabilitation Centre Reade: J.J.E. Adriaansen, W.J. Achterberg-Warmer; Rehabilitation Centre Sint Maartenskliniek: H. Bongers-Janssen, I.J.W. van Nes, M. Vos-van der Hulst; Rijndam Rehabilitation: D.C.M. Spijkerman, R. Osterthun, T. Sluis; and UMCG Centre for Rehabilitation: G.E. van der Wal, E.H. Roels, M. Tepper. The DSCID project management group consists of C.A.M. van Bennekom, J. Nachtgaal, R. Osterthun, M.W.M. Post, E.H. Roels, E.W.M. Scholten and J.M. Stolwijk-Swüste.

Funding

Quality Funds Foundation of Dutch Medical Specialists (SKMS; grant no. Z69044861).

Author information

Authors and Affiliations

  1. Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    Claire G. Poublon, Eline W. M. Scholten, Marcel W. M. Post & Janneke M. Stolwijk-Swüste

  2. Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands

    Michel I. A. Wyndaele

  3. University of Groningen, University Medical Centre Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands

    Marcel W. M. Post

Authors
  1. Claire G. Poublon
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Contributions

CP writing the paper with input from all authors. CP, ES, MP conceiving and designing the analysis. CP, ES analysing data. CP, ES, MW, MP, JS interpreting results. ES, MW, MP, JS feedback on the report. JS supervised.

Corresponding author

Correspondence to Janneke M. Stolwijk-Swüste.

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Competing interests

The authors declare no competing interests.

Ethical approval

The DSCID did not need formal ethical approval because this type of study does not fall within the scope of the Dutch law on Medical Research [29]. Nevertheless, the local ethical committees and boards of all participating centres approved the provision of anonymized data on their patients for the DSCID. This study was conducted according to the Helsinki II declaration.

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Poublon, C.G., Scholten, E.W.M., Wyndaele, M.I.A. et al. Changes in bladder emptying during inpatient rehabilitation after spinal cord injury and predicting factors: data from the Dutch Spinal Cord Injury Database. Spinal Cord 61, 624–631 (2023). https://doi.org/10.1038/s41393-023-00925-y

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