A Retrospective Study on the Level of Independence in Bladder and Bowel Sphincter Control Between Complete versus Incomplete Spinal Cord Injury Patients Discharged in a Public Orthopedic Specialty Hospital from January 2019 to January 2020

ABSTRACT

INTRODUCTION

Functional outcomes of spinal cord injury (SCI) patients showed that they remain dependent   in terms of bowel and bladder management. The Spinal Cord Independence   Measure (SCIM) was developed in response to the need to quantify the improvement of SCI patients. It includes all injuries and classifications   including the sphincter subscales as it relates to sphincter control, hence,   improving standards of care and quality of life.

OBJECTIVES

The primary objective is to compare the bladder and  bowel independence between complete and incomplete SCI patients discharged in a public orthopedic specialty hospital from January 2019 to January 2020.

RESULTS

A total of 108 patients were included in the study. For bladder function, during admission, those with complete injuries   had increased risk for assisted bladder function (OR=9.47, 95%CI=1.21 –   74.31, p=0.01), and upon discharge, those  with complete injuries still had increased risk for assisted bladder function (OR=2.84, 95%CI=1.12   – 7.20, p=0.02). For bowel function, those with higher   ASIA scores had less risk for assisted bowel function (OR=0.4, 95%CI=0.3-0.7,   p=0.002), and upon discharge, those with complete injuries had increased risk   for assisted bowel function (OR=3.66, 95%CI=1.26-10.61, p=0.013). The study   also showed that spinal surgery   has no significant correlation with bladder and bowel independence.

CONCLUSION

Patients with complete injury have increased risk   of having assisted bladder and bowel function. Factors that contribute to bladder and bowel independence include patient’s age, whether they have complete or incomplete injury, and their ASIA scores. Spinal surgery has no significant correlation with bladder and bowel independence in patients with SCI.