METHODS: This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or nontraumatic spinal cord injury participating in the International Spinal Cord Injury Community Survey from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection, and quality of life score were extracted from the International Spinal Cord Injury Community Survey questionnaire. The impact of bladder care and urinary complications on quality of life was determined using univariable and multivariable regression analysis.
RESULTS: Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and spinal cord injury-related data, secondary conditions, as well as activity and participation factors, urinary tract infection was an independent negative predictive factor of quality of life score ( P = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method).
CONCLUSIONS: Among bladder care and urinary complication factors, urinary tract infection is the only factor negatively impacting quality of life. These results address the importance of proper bladder management and urinary tract infection prevention in persons with spinal cord injury to improve their quality of life.
DESIGN: A cross-sectional study.
METHODS: Data from the International Spinal Cord Injury Community Survey (InSCI) were analyzed. The PI problems were assessed using the Spinal Cord Injury Secondary Condition Scales (dichotomized to "having problem" and "not having problem". Health service systems were categorized as an inpatient-oriented SCI specialized system and a primary care-oriented system. A directed acyclic graph was applied to create a multivariable logistic regression model to determine the independent influencing factors of PI problems.
RESULTS: Of 790 included participants, 277 (35%) had PI problems. Being recruited from countries with inpatient-oriented SCI specialized systems (Model 1) and visiting rehabilitation medicine/SCI physicians at least once a year (Model 2) is an independent negative correlating factor of PI problems (odds ratio = 0.569 [95%CI: 0.374-0.866] and 0.591 [95%CI: 0.405-0.864], respectively).
CONCLUSION: SCI-specialized health service systems might be a protective factor of PI problems in middle-income country contexts. This result suggests the importance of having SCI-specialized services in middle-income countries to reduce the prevalence of PI problems.