Urinary diversion in patients with spinal cord injury in the United States.

Abstract:

OBJECTIVE:To describe the patterns in the use of bladder augmentation and urinary diversion to manage urologic sequelae among patients with spinal cord injury in the United States. MATERIALS AND METHODS:Discharge estimates were derived from the Nationwide Inpatient Sample. All patients underwent bladder augmentation or ileal conduit diversion from 1998 to 2005 and had a diagnosis of spinal cord injury. RESULTS:Ileal loop diversion was performed in an estimated 1919 patients and bladder augmentation in 1132 patients with spinal cord injury from 1998 to 2005. Patients undergoing urinary diversion tended to be older (mean age 46 vs 34 years; P <.001) and to have Medicare as the primary payer (55.0% vs 30.8%; P <.001). Patients who underwent urinary diversion appeared to use more healthcare resources, with a longer length of stay (15 vs 9 days), higher hospital charges ($58,626 vs $37,222), and a greater use of home healthcare services after discharge (all P <.001). Patients at teaching institutions were more likely to undergo bladder augmentation (42%) than those at nonteaching institutions (23%; P <.001). CONCLUSION:Bladder augmentation is used in approximately one-third of cases to manage the urologic complications of spinal cord injury. These patients likely constitute a clinically distinct population that uses fewer healthcare resources. The lower augmentation rates at nonteaching institutions may indicate an opportunity for quality improvement.

journal_name

Urology

journal_title

Urology

authors

Peterson AC,Curtis LH,Shea AM,Borawski KM,Schulman KA,Scales CD Jr

doi

10.1016/j.urology.2012.06.063

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1247-51

issue

6

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(12)00925-9

journal_volume

80

pub_type

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