1250 - Acute Bladder Management in Spinal Cord Injury Patients: A Retrospective Study

Objectives: Clinical guidelines recommend bladder outputs from clean intermittent catheterization (CIC) be less than 500mL, but the incidence of guideline-concordant bladder management in the acute care setting has not been reported in the spinal cord injury (SCI) population. The purpose of this study was to characterize a sample of patients with SCI admitted to the acute hospital and bladder management for this population.

Design: This is a retrospective cohort study of adults admitted to an acute hospital for SCI between September 2021 and September 2023 and unable to spontaneously void. Patient and clinical data were extracted from the electronic medical record. Descriptive statistics were calculated for patient demographics, hospital length of stay, and bladder management ( >500mL).

Results: The final sample comprised 711 patients and 920 hospital admissions with a mean (SD) age of 55.6 (19.5) years. Over half of the cohort was male (62.4%); 47.7% identified as Black and 42.3% as White. The majority were covered by public insurance (52.1% by Medicare and 29.3% by Medicaid). 24.5% of patients had a SCI at the cervical level and 75.5% at the thoracolumbar level. Mean (SD) hospital length of stay was 16.9 (32.4) days for cervical SCI and 12.9 (20.0) days for thoracolumbar SCI. 43.5% of admissions involved bladder management with CIC. Of these, 64.8% had at least one CIC volume >500mL during admission and 34.9% of all CIC volumes were >500mL.

Conclusions: The overall population of adults with SCI in the acute hospital setting was diverse in age, race, and insurance type. Bladder volumes exceeded what is recommended by guidelines in one-third of cases. Ongoing analyses are examining the rates of urinary tract infection by bladder management strategy, especially among those with higher frequency of bladder output >500mL, and associations with patient outcomes.