# Bladder management for adults with spinal cord injury in the acute hospital setting: A retrospective study

## TL;DR

This study examines bladder management practices in adults with spinal cord injuries during hospital stays and how these practices affect the length of hospitalization.

## Contribution

The study provides new insights into bladder management patterns and their impact on hospital stay duration for individuals with spinal cord injuries.

## Key findings

- Nearly half of admissions required no urinary catheter, while IUC-only and CIC methods were used in 18.9% and 15.7% of cases, respectively.
- Combined IUC and CIC management was associated with a 10.7-day increase in hospital stay for those with cervical injuries.
- Most admissions used a single bladder management strategy, with 63.1% of the combined group trying CIC more than once.

## Abstract

Retrospective cohort study.

The purpose of this study was to describe bladder management during acute hospitalization for people with SCI and its association with length of hospitalization.

Acute hospitals within a single academic health system in the United States of America.

Data were extracted from the electronic health record for admissions between September 1, 2021, and September 30, 2023. Bladder management for all admissions was classified as either indwelling urinary catheter (IUC), clean intermittent catheterization (CIC), IUC and CIC, or no catheter. The relationship between bladder management, injury type, and length of stay was examined using a mixed effects linear regression model.

The final sample included 1169 unique patients and 1652 admissions. Half (49.7%) of admissions required no urinary catheter. The IUC-only group comprised 18.9% of admissions while CIC and the combined IUC and CIC groups comprised 15.7% of admissions. Most admissions (84.3%) included a single bladder management strategy. Up to 63.1% of the combined IUC and CIC group implemented a trial of CIC more than once during the admission. Both IUC and CIC management was associated with a significant increase in hospital stay of 10.7 days (95% CI [5.3, 16.1], P < 0.001) for those with a cervical injury.

These results provide valuable information about existing care patterns that can guide future quality improvement initiatives to enhance bladder management early after SCI.