Abstract
Characteristics and related factors of urinary tract infections during the rehabilitation phase in patients with spinal cord injury
  
DOI:10.3870/zgkf.2025.04.005
EN KeyWords: spinal cord injury  urinary tract infection  asymptomatic bacteriuria  symptomatic urinary tract infection  risk factors  rehabilitation phase
Fund Project:四川省科技计划项目(2024NSFSC0539)
作者单位
张佳熠 1.四川大学华西医院康复医学中心成都 610041 
李诗欣 1.四川大学华西医院康复医学中心成都 610041 
骆沁熹 1.四川大学华西医院康复医学中心成都 610041 
杨永红 1.四川大学华西医院康复医学中心成都 6100412.康复医学四川省重点实验室成都 610041 
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EN Abstract:
  Objective: To investigate the characteristics and risk factors associated with urinary tract infections (UTI) during the rehabilitation phase in patients with spinal cord injury (SCI). Methods: A retrospective analysis was conducted on electronic medical records of 2101 SCI patients treated in our rehabilitation department from 2013 to 2023. Demographic information, clinical features, and laboratory indicators were collected through the electronic medical record system. Patients were categorized into a non-infection group, an asymptomatic bacteriuria (ASB) group, and a symptomatic UTI group based on their UTI status. Multinomial logistic regression was used to analyze risk factors associated with UTI. Results: The incidence of UTI in SCI patients was 74.0%, 41.8% in ASB group and 32.9% in symptomatic UTI group. Laboratory analysis indicated that inflammatory markers were significantly higher in symptomatic UTI patients than in the no-infection and ASB groups. Multinomial logistic regression revealed that female gender (ASB: OR=2.66; symptomatic UTI: OR=1.96) and neurogenic bladder (ASB: OR=1.97; symptomatic UTI: OR=3.94) were shared risk factors for both ASB and symptomatic UTI. Indwelling catheterization (OR=2.17), renal impairment (OR=1.35), and anticholinergic drug use (OR=1.39) were significantly associated with symptomatic UTI. Lower injury levels and coexisting pulmonary infections appeared protective against UTI, with D-level injury (OR=0.54) and pulmonary infections (OR=0.58) significantly reducing ASB risk, and C-level (OR=0.57), D-level (OR=0.28), and E-level (OR=0.47) injuries significantly lowering the risk of symptomatic UTI. Conclusion: The incidence of UTI is high among SCI patients during the rehabilitation phase, with distinct clinical features and risk factors for ASB and symptomatic UTI. Differentiated prevention and treatment strategies should be implemented based on the type of UTI, with enhanced monitoring and intervention for high-risk patients to improve quality of life.
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