Disclosures: Cynthia Pham, MD Candidate 2021: No financial relationships or conflicts of interest

Objective: This study aims to determine the incidence, severity, and impact of genitourinary specific autonomic dysreflexia (AD) in SCI patients using indwelling catheters (IDC).

Design: The Urinary Symptom Questionnaire for Neurogenic Bladder for those who use IDC is a validated patient-centered patient reported outcome measure used to monitor 26 urinary symptoms which occur most commonly in this population. The survey was completed bi-monthly for 12 months. Setting : Surveys were answered online in the participants’ natural setting. Participants : Participants had a SCI diagnosis for greater than 1 year and use IDC for bladder management

Interventions: There was no intervention.

Main Outcome Measures: Participants were asked to rate the severity and impact of positive symptoms. The choices were: not at all-, somewhat-, severe, or very- severe, and hardly- , somewhat- , considerably-, or completely- affects my daily life. Antibiotic use was also reported.

Results: Of 54 participants, 46 had a level of injury (LOI) above T6 and would be at risk for AD. 5 participants were lost to follow-up and 1 died. Of the remaining 40 participants, 32.50% of subjects endorsed experiencing AD one or more times, totaling 50 endorsements in 1 year. All included subjects had a LOI above C7 (53.84% complete, 46.15% incomplete). With the removal of one outlier, the range of AD episodes per year was 1-6 endorsements (mean=2.00+/-1.60; n=12). 33.33% reported that AD was “not at all severe” and 66.67% reported other severity level. 29.17% reported that AD was “hardly” impactful and 70.83% reported other impact level. During these episodes, 58.33% were taking antibiotics. 37.50% reported UTI specific antibiotic use. The absolute risk of experiencing AD was 0.17 episodes/person-year. Conclusions: Despite low incidence of AD, it is a life threatening condition that manifested severely in 33.33% and caused a considerable impact in 20.83% for participants. Therefore, clinicians should consider counseling patients about the risk of AD occurrence during UTI.

Level of Evidence: Level I

« Back to AAPM&R Annual Assembly 2020

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/severity-and-impact-of-autonomic-dysreflexia-as-a-symptom-of-urinary-tract-infection-in-spinal-cord-injury-patients-who-use-an-indwelling-catheter/