Study design

Retrospective chart audit.

Objectives

To evaluate the safety of ultrasound-guided percutaneous suprapubic catheter (SPC) insertion in patients with spinal cord injury/disease (SCI/D) and to attempt to identify risk factors for complications.

Setting

Specialized German centre for spinal cord injuries.

Methods

This retrospective chart analysis evaluated demographic, neurologic, and neuro-urologic data and the incidence and type of complications within the first 30 days after suprapubic bladder catheter insertion in SCI/D patients in the period between January 1st, 2013, and December 31st, 2022.

Results

The data of 721 SCI/D patients (244 women and 477 men, 386 tetraplegics and 355 paraplegics) were analysed. There were 44 complications (6.5%), of which 11 (1.5%) were major complications according to Clavien–Dindo ≥ 3. Among these were one small bowel injury and one peritoneal injury each, but no fatal complications. Regarding major complications (according to Clavien–Dindo ≥3), only patient age was identified as a risk factor (p = 0.0145). Gender, SCI/D level, neurological completeness, and severity of SCI/D or type of neurogenic lower urinary tract dysfunction (Odds ratio [95% CI] 1.6423 [0.4961;5.4361], 1.0421 [0.3152;3.4459], 0.3453 [0.0741;1.6101], 2.8379 [0.8567;9.4004] and 2.8095 [0.8097;9.7481] respectively) did not show any association with the frequency of major complications.

Conclusions

Mild complications, especially temporary hematuria or infectious complications, are not uncommon after SPC insertion in SCI/D patients. Major complications occur only rarely, and no risk factor other than age could be detected. On this basis, pre-intervention education on informed consent for SCI/D patients can be provided on an evidence-based approach.

中文翻译：

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超声引导下经皮耻骨上导管置入脊髓损伤患者的安全性

 学习规划

回顾性图表审核。

 目标

评估超声引导下经皮耻骨上导管 (SPC) 插入脊髓损伤/疾病 (SCI/D) 患者的安全性，并尝试确定并发症的危险因素。

 环境

德国脊髓损伤专业中心。

 方法

该回顾性图表分析评估了 2013 年 1 月 1 日至 2022 年 12 月 31 日期间 SCI/D 患者耻骨上膀胱导管插入后前 30 天内的人口统计学、神经系统和神经泌尿系统数据以及并发症的发生率和类型。

 结果

对 721 名 SCI/D 患者（244 名女性和 477 名男性、386 名四肢瘫痪者和 355 名截瘫者）的数据进行了分析。并发症 44 例（6.5%），其中 11 例（1.5%）为 Clavien-Dindo ≥ 3 级严重并发症。其中小肠损伤 1 例，腹膜损伤 1 例，但无致命并发症。关于主要并发症（根据 Clavien-Dindo ≥3），仅患者年龄被确定为危险因素（p = 0.0145）。性别、SCI/D 水平、神经系统完整性以及 SCI/D 或神经源性下尿路功能障碍类型的严重程度（比值比 [95% CI] 1.6423 [0.4961;5.4361]、1.0421 [0.3152;3.4459]、0.3453 [0.0741;分别为 1.6101]、2.8379 [0.8567;9.4004] 和 2.8095 [0.8097;9.7481]) 与主要并发症的发生率没有任何关联。

 结论

SCI/D 患者置入 SPC 后，轻度并发症，尤其是暂时性血尿或感染性并发症并不少见。主要并发症很少发生，除年龄外无法检测到任何危险因素。在此基础上，可以循证对SCI/D患者进行知情同意干预前教育。