Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study

Study design: Cross-sectional survey of the Neurogenic Bladder Research Group (NBRG) registry; a multicenter prospective observation study. Objectives: To assess how patient-reported urinary tract infections (PRUTIs) in spinal cord injury (SCI) affect quality of life (QOL). Setting: Multiple United States hospitals. Methods: 1479 participants with SCI were asked about neurogenic bladder-related QOL. Eligibility: age ≥ 18 years with acquired SCI. PRUTI frequency over the last year was classified as 0, 1–3, 4–6, or >6. Four UTI QOL domains were assessed: (1) UTIs limited daily activities, (2) UTIs caused increased muscle spasms, (3) UTIs would not go away, and (4) UTIs made me avoid going out. Multivariable regression identified variables associated with poor QOL. Results: PRUTI frequency was 0 in 388 patients (26%), 1–3 in 677 (46%), 4–6 in 223 (15%), and more than 6 in 190 (13%). Increasing PRUTI rate was independently associated with worse QOL for all four questions. Compared with those with 0 PRUTIs, participants reporting >6 were more likely to limit daily activities (OR 9.0 [95% CI 8.1–21.2] p < 0.0001), experience increased muscle spasms (OR 12.4 [95% CI 7.5–20.6] p < 0.0001), perceive a UTI would not go away (OR 30.1 [95% CI 15.0–60.4] p < 0.0001), and avoid going out because of UTIs (OR 7.2 [95% CI 4.2–12.4] p < 0.0001). Conclusions: An increasing rate of PRUTIs is independently associated with worse QOL. Thorough evaluation and treatment may improve QOL in this population.