Retrospective Cohort Study of Patient-Reported Urinary Tract Infection Signs and Symptoms Among Individuals With Neurogenic Bladder.
Marissa Wirth, Katie J Suda, Stephen P Burns and 6 others
PMID 36927768WHAT IT FOUND
Among patients with neurogenic bladder and suspected UTI, fever, urine odor or color changes, and lethargy were the most common documented signs.
Only 38% had any urinary tract-specific symptom, so non-specific findings alone should not be read as proof of infection.
Key findings
01Fever was the most frequent symptom (32%), followed by change in urine odor, color, or consistency (25%) and lethargy or malaise (21%).
02Only 38% of patients had at least one urinary tract-specific sign or symptom, while 48% had only non-specific signs or symptoms.
03Inpatient encounters had greater odds of only non-specific signs or symptoms compared with outpatient encounters (OR 2.5; 95% CI 1.2-5.2), and emergency department encounters had greater odds of at least one urinary tract-specific sign or symptom (OR 2.7; 95% CI 1.1-6.6).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used VA records only, so symptoms reported by patients with neurogenic bladder outside the VA may differ. Veterans who receive care outside the VA were not captured, so some encounters may be missing. Neurologic diagnosis, neurogenic bladder, and UTI status were based largely on ICD-10-CM codes, which may not be entered accurately for every encounter. The sample was small for adjusted analyses, so other factors may have influenced the symptom patterns. Results depend on what was written in provider notes, nursing notes, and vital signs, so undocumented symptoms may have been missed. The chart-review sample was selected for a larger study, and this sub-analysis did not have its own power calculation.
Declared interests
The article is tagged as supported by U.S. Government, non-P.H.S. research support. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not read fever, urine odor or color changes, or lethargy as proof of UTI in patients with neurogenic bladder. The study found these non-specific signs and symptoms were common, and only 38% had a urinary tract-specific sign or symptom. It does not test an intervention or show that treating these symptoms improves outcomes.