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Risk factors predicting upper urinary tract deterioration in children with spinal cord injury
Author(s) -
Önal Bülent,
Kırlı Elif A.,
Selçuk Berin,
Buğdaycı Derya,
Can Günay,
Çetinel Bülent
Publication year - 2021
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24580
Subject(s) - medicine , spinal cord injury , receiver operating characteristic , upper urinary tract , urinary system , etiology , radiological weapon , surgery , spinal cord , psychiatry
Aim The aim of this study is to determine the risk factors predicting upper urinary tract (UUT) deterioration in children with spinal cord injury (SCI). Methods The medical records of 108 children with SCI who were referred to our unit between 1996 and 2018 were retrospectively reviewed. The data included general patient demographics, SCI characteristics, bladder management methods, presence of urinary tract infection, radiological evaluation of the UUT and lower urinary tract (LUT), and videourodynamic findings. The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff values of the maximum detrusor pressure during filling and the bladder volume ratio (BVR) for predicting UUT deterioration. Multivariate analyses were used to determine the risk factors predicting UUT deterioration. Results Complete data were available for 76 children. The median patient age was 15 years (2–17). The leading causes of SCI were motor vehicle accidents (44%) and fall (33%). UUT deterioration was identified in 33 patients (43%). Iatrogenic SCI etiology, abnormal radiological LUT findings, and detrusor pressures greater than 70 cmH 2 O were found to be independent risk factors for UUT deterioration using regression analysis. In addition, ROC analysis revealed that a BVR less than 0.7 was the cutoff value for UUT deterioration in children with SCI. Conclusion Abnormal radiological LUT findings, iatrogenic SCI etiology, detrusor pressure greater than 70 cmH 2 O, and a BVR less than 0.7 were independent risk factors for UUT deterioration in children with SCI.