NEW ORLEANS, LA USA (UroToday.com) - Dr. Anne Cameron highlighted the difficulty that spinal cord injury patients face in obtaining care and the obstacles to maintaining good health in this high-risk population. Her group’s work evaluated a nationwide 5% Medicare sample from 2007-2010 with the hypothesis that medical complications would be high in this population and that most patients with spinal cord injury do not get the minimum recommended surveillance over a 2-year period. They defined this based on the recommendations by the Paralyzed Veterans of America that these patients should receive a minimum of a serum creatinine, some form of upper tract imaging, and a visit with a urologist.
Their objectives were to evaluate the completeness of the screening, the predictors of having complete screening, as well as the occurrence of medical complications in this population.
The Medicare claims data included 7 162 patients with spinal cord injury, with 24.5% receiving complete screening, and 70.5% receiving some screening. The rate of severe complications was 8%, moderate complications was 17.1%, and minor complications was 35.8%. Distance traveled to reach care (a urologist or physical medicine provider) did not predict complications. Complications were more likely for those patients of male gender, African American race, and who had some form of screening, likely due to the inability to differentiate for-cause and screening tests in this type of data.
Dr. Cameron and colleagues were commended by the moderators and audience for their efforts in conducting much needed population-based epidemiologic studies in this high-risk population. These efforts can assist experts create future practice guidelines.
Presented by Anne P. Cameron at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
University of Michigan, Ann Arbor, MI USA
Reported by Lindsey Cox (University of Michigan, Ann Arbor, MI USA), medical writer for UroToday.com