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

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The purpose of this study was to describe bladder management during acute hospitalization for people with SCI and its association with length of hospitalization. SETTING: Acute hospitals within a single academic health system in the United States of America. METHODS: 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. RESULTS: 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. CONCLUSION: These results provide valuable information about existing care patterns that can guide future quality improvement initiatives to enhance bladder management early after SCI.