Association of stone surgery with patient-reported complications after spinal cord injury

Khushabu Kasabwala, Michael Borofsky, Shawn T Grove, Sara M. Lenherr, Jeremy B. Myers, John T. Stoffel, Blayne Welk, Sean P. Elliott

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: To determine if a history of urinary stone surgery in individuals with spinal cord injury (SCI) is associated with an increased incidence of SCI-related complications and lower quality of life (QOL).

METHODS: The Neurogenic Bladder Research Group (NBRG) registry is a multicenter, prospective, observational study which measures QOL after acquired SCI. Over 1.5 years, 1479 participants were enrolled and grouped according to history of stone surgery. We evaluated SCI-related complications, QOL, and associations between patient factors and prior stone surgery using multivariable regression.

RESULTS: Participants were a median of 11 years post-SCI and 189 (12.8%) reported prior bladder or kidney stone surgery; 95.8% of these occurred after the SCI. Median time between SCI and first stone was 5.6 years (IQR: 1.8-12.8). Hospitalizations were higher for those with prior stone surgery, with common reasons including UTIs, blood clots, pressure ulcers, and pneumonia (p < 0.001). During the year of observation, the incidence of stone surgery was 17% in those with a prior history of stone surgery and 2% per year in those without prior stone surgery (p < 0.001). Controlling for covariates, bladder management strategy, age, BMI, and years since SCI were associated with history of stone surgery.

CONCLUSIONS: People with SCI and a history of surgical stone disease are at high risk for episodes of recurrent stones and increased hospitalizations, particularly those with kidney stones and indwelling catheter use. Identification of high-risk patients may guide tailored surveillance for complications and stone prevention strategies.

Original languageEnglish (US)
Pages (from-to)820-829
Number of pages10
JournalNeurourology and Urodynamics
Volume41
Issue number3
DOIs
StatePublished - Mar 2022

Bibliographical note

Funding Information:
We would like to acknowledge the PatientCentered Outcomes Research Institute (PCORI) for financial assistance with the development of the data registry on which this project is based. We would also like to thank the Neurogenic Bladder Research Group (NBRG) for their help with, and support of, this project. This study was partially supported through a Patient‐Centered Outcomes Research Institute (PCORI) Award (CER14092138). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI.

Publisher Copyright:
© 2022 Wiley Periodicals LLC

Keywords

  • bladder stones
  • nephrolithiasis
  • quality of life
  • spinal cord injury
  • stone surgery

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

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