1. Risk factors to develop autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury.
- Author
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Vírseda-Chamorro M, Salinas-Casado J, Gutiérrez-Martín P, de la Marta-García M, López-García-Moreno A, and Esteban Fuertes M
- Subjects
- Adult, Age Factors, Aged, Autonomic Dysreflexia physiopathology, Blood Pressure, Cross-Sectional Studies, Female, Heart Rate, Humans, Male, Middle Aged, Prevalence, Risk Factors, Spinal Cord Injuries physiopathology, Urinary Bladder physiopathology, Urinary Incontinence epidemiology, Urinary Incontinence physiopathology, Autonomic Dysreflexia epidemiology, Autonomic Dysreflexia etiology, Physical Examination adverse effects, Spinal Cord Injuries complications, Spinal Cord Injuries epidemiology, Urodynamics
- Abstract
Aims: The risk factors for developing autonomic dysreflexia (AD) during urodynamic (UD) examination in patients with spinal cord injury (SCI) above Th6 still remain unclear. The main goal of our study is to investigate the risk factors that could be associated with AD in these particular patients., Design: Cross sectional survey., Subject and Methods: The study was carried out in 83 patients with SCI above Th6 who were submitted to our center for a UD examination. AD was defined as a rise in systolic blood pressure above 15 mm Hg with a pulse rate below 60 beats per minute., Results: The prevalence rate of AD among our patients was 54%. Univariate analysis of our study showed the following risk factors: patient's age, SCI completeness, traumatic etiology, indwelling catheter, presence of chills or sweating, anticholinergic treatment, maximum detrusor voiding pressure, detrusor pressure at maximum flow rate, detrusor external sphincter dyssynergia, and bladder outlet obstruction. Using multivariate logistic regression, we found that there are only two independent risk factors: patient's age equal to or above 45 years of age (OR = 10.995) and maximum detrusor voiding pressure equal to or above 31 cm H
2 O (OR = 3.879)., Conclusions: According to our results, the patient's age and maximum detrusor voiding pressure should be considered at the time of performing a UD examination in order to prevent the sudden onset of AD in patients with SCI above Th6. Neurourol. Urodynam. 36:171-175, 2017. © 2015 Wiley Periodicals, Inc., (© 2015 Wiley Periodicals, Inc.)- Published
- 2017
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