Significance of UTI in SCI  

Facts about UTI in SCI patients

  • UTI was the second most frequently reported complication in chronic SCI with an annual incidence of 20% [Whiteneck 1992].
  • The overall rate of UTI in SCI patient is about 1.82-2.5 episodes per patient per year [Waites 1993; Siroky 2002].
  • UTIs interfere with rehabilitation, and may lead to secondary urologic complications [Garcia 2003]
  • Genital infections can lower fertility in SCI patients [Allas 1986]

UTI-related Mortality

  • Death due to chronic renal failure is now unusual, whereas septicemia, in many cases from a UTI, remains a leading cause of death [DeVivo 1993].
  • UTIs and other urologic complications were a primary cause of death after SCI [Burke 1960; Freed 1966].
  • Mortality from urinary sepsis is 10-15% in patients with SCI [Whiteneck 1992].
Key Points of This Section
  • UTI is common in SCI patients and can be dangerous if obstruction is present and bladder pressures are high.
  • Other factors as stone formation, foreign bodies in the urinary tract (catheters), loss of ureteral peristalsis related to chronic obstruction play a role, but control of pressure is the most effective method to ameliorate the risk of chronic bacteriuria.

References

  • Allas T, Colleu D, Le Lannon D. Fonction génitale chez l'homme praplégique. Aspects immunologiques. Presse Med 1986; 29: 2119.
  • Burke MH, Hicks AF, Robins M, Kessler H. Survival of patients with injuries of the spinal cord. JAMA. 1960 Jan 9;172:121-4.
  • DeVivo MJ, Black KJ, Stover SL. Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil. 1993 Mar;74(3):248-54.
  • Freed MM, Bakst HJ, Barrie DL. Life expectancy, survival rates, and causes of death in civilian patients with spinal cord trauma. Arch Phys Med Rehabil. 1966 Jul;47(7):457-63.
  • Garcia Leoni ME, Esclarin De Ruz A. Management of urinary tract infection in patients with spinal cord injuries.Clin Microbiol Infect. 2003 Aug;9(8):780-5.
  • Siroky MB. Pathogenesis of bacteriuria and infection in the spinal cord injured patient. Am J Med. 2002 Jul 8;113 Suppl 1A:67S-79S.
  • Waites KB, Canupp KC, DeVivo MJ. Epidemiology and risk factors for urinary tract infection following spinal cord injury. Arch Phys Med Rehabil 1993; 74: 691-5.
  • Whiteneck GG, Charlifue SW, Frankel HL, Fraser MH, Gardner BP, Gerhart KA, Krishnan KR, Menter RR, Nuseibeh I, Short DJ, et al. Mortality, morbidity, and psychosocial outcomes of persons spinal cord injured more than 20 years ago. Paraplegia. 1992 Sep;30(9):617-30.

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