MP07-15 WHAT IS THE ASSOCIATION OF SEVERE BOWEL SYMPTOMS AND TYPE OF NEUROGENIC BLADDER MANAGEMENT IN PATIENTS WITH SPINAL CORD INJURY
Bibliographic record
Abstract
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP07)1 Apr 2019MP07-15 WHAT IS THE ASSOCIATION OF SEVERE BOWEL SYMPTOMS AND TYPE OF NEUROGENIC BLADDER MANAGEMENT IN PATIENTS WITH SPINAL CORD INJURY Paholo Barboglio Romo*, Iryna Crescenze, Sara Lenherr, Jeremy Myers, Blayne Welk, Sean Elliott, Diana O'Dell, Angela Presson, and John Stoffel Paholo Barboglio Romo*Paholo Barboglio Romo* More articles by this author , Iryna CrescenzeIryna Crescenze More articles by this author , Sara LenherrSara Lenherr More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Blayne WelkBlayne Welk More articles by this author , Sean ElliottSean Elliott More articles by this author , Diana O'DellDiana O'Dell More articles by this author , Angela PressonAngela Presson More articles by this author , and John StoffelJohn Stoffel More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555099.30133.4bAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Bowel dysfunction and severe bowel symptoms are common in Spinal Cord Injured (SCI) patients. The aim of this study was to investigate predictors for severe bowel symptoms in SCI patients and whether type of neurogenic bladder management plan was associated with more severe bowel symptoms. METHODS: The Neurogenic Bladder Research Group (NBRG) registry is a multicenter, prospective, observational study, which measures neurogenic bladder (NGB) related quality of life (QOL) after SCI. Eligibility included: age ≥18 years and acquired SCI. Over 1.5 years, 1479 eligible participants were enrolled. Univariate analysis and mixed binomial logistic regression analysis was used evaluate associations between QoL and demographic variables. Bowel symptoms were assessed by Neurogenic Bowel Dysfunction score and patients scoring > 14 were categorized as having severe bowel symptoms. Bladder management was categorized as: voiding, clean intermittent catheterization (CIC), surgery (augmentation/diversion) or indwelling catheter. RESULTS: Baseline demographics are displayed in Table 1. There were 585 (40%) individuals with severe symptoms and 894 with non-severe. SCI patients performing CIC had the highest percentage of people reporting severe bowel symptoms (48%) followed by indwelling (25%), surgery (16%), and voiding (12%) (p<0.001). Other variables associated with severe bowel symptoms were high (>T6) level of injury (p=0.005), incomplete injury (p=0.025) and autonomic dysreflexia (p=0.048). The presence of colostomy (p<0.001) and SF-12 (physical) questionnaire (p=0.037) were protective. All these were modeled into mixed binomial logistic regression analysis and only AD (p<0.001) and type of management were significantly associated with more severe symptoms. The odds risk (OR) for CIC was 0.74 (95%CI:0.56-0.97), surgery OR 0.52 (95%CI:0.38-0.71), Indwelling OR 0.39 (95%CI:0.29-0.52) when compared to voiding. CONCLUSIONS: Severe bowel symptoms are significantly associated to the management type of neurogenic bladder and the presence of AD. Patients with indwelling catheter and those who underwent surgery had lower risk of severe bowel symptoms. Urologist should assess both bladder and bowel symptoms when counseling on type of management for neurogenic bladder. Source of Funding: none Ann Arbor, MI; Salt Lake City, UT; London, Canada; Minneapolis, MN; Ann Arbor, MI; Salt Lake City, UT; Ann Arbor, MI© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e96-e96 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paholo Barboglio Romo* More articles by this author Iryna Crescenze More articles by this author Sara Lenherr More articles by this author Jeremy Myers More articles by this author Blayne Welk More articles by this author Sean Elliott More articles by this author Diana O'Dell More articles by this author Angela Presson More articles by this author John Stoffel More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.121 | 0.025 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".