Genitourinary Complications Are a Leading and Expensive Cause of Emergency Department and Inpatient Encounters for Persons With Spinal Cord Injury.
Felicia Skelton, Jason L Salemi, Lois Akpati and 4 others
PMID 30935942WHAT IT FOUND
Genitourinary complications were the main diagnosis in 8.2% of spinal cord injury hospitalizations and 18.7% of emergency visits, appeared in more than half of hospitalizations overall, and were tied to about half of related costs.
Key findings
01A GU complication was the principal diagnosis in 8.2% of SCI-related inpatient hospitalizations and 18.7% of SCI-related ED visits, but it appeared among other diagnoses in more than half of inpatient and more than one-third of ED visits.
02Approximately $4.3 billion in annual direct medical costs were associated with SCI hospitalizations and ED visits, and approximately half of all SCI-related costs nationally were associated with encounters during which a GU complication was present.
03The proportion of SCI hospitalizations with a GU complication as any diagnosis increased 2.5% each year from 2006 to 2011 and 0.9% each year from 2011 to 2015.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used administrative discharge records, so the accuracy of the spinal cord injury and genitourinary complication codes cannot be confirmed by chart review. The records do not contain signs or symptoms to confirm a genitourinary complication, nor how the patient managed the bladder. The injury-level groups are broad and heterogeneous because more detailed level of injury information was unavailable. The databases are cross-sectional and lack patient identifiers, so the analysis is per encounter and cannot follow the same person across readmissions, repeat emergency visits, or longer-term outcomes. Emergency department costs had to be estimated using inpatient spinal cord injury-related cost-to-charge ratios because the emergency department database did not supply hospital-specific ratios. The study does not test an intervention, so it cannot show that any prevention or treatment approach reduced complications or costs.
Declared interests
The article text does not include a conflict-of-interest or funding declaration. The supplied publication types list research support from U.S. and non-U.S. government sources.
The easy way to misread this
Do not read the high cost and prevalence as proof that a specific prevention program works. The study used coded administrative encounters, not confirmed diagnoses, and it cannot link the same person across visits, so it shows burden and associations, not treatment effects.