Physiologic Differences in Vital Signs and Urine Tests in Spinal Cord Injury and the Effects on Urinary Tract Infection Diagnosis.

Abstract

The aim of the study was to establish the physiologic baseline (person's physiologic state when their health is stable) for vital signs and urine lab measurements after spinal cord injury. This case-control study using outpatient data from the national Veteran's Health Administration Corporate Data Warehouse included 2000 veterans with spinal cord injury (cases) and 2000 Veterans without spinal cord injury (controls) between 2018-2019. Cases and controls were randomly selected, and frequency matched for age, sex, race, ethnicity, and Deyo Comorbidity Index. Spinal cord injury patients had lower temperature, heart rate, respiratory rate, and systolic and diastolic blood pressures than non-spinal cord injury ( P < 0.05). Pyuria and hematuria were higher in spinal cord injury patients, with approximately 73% of tetraplegic and paraplegic patients having urine white blood cells above 10 high power field. Tetraplegic patients had lower heart rate, systolic blood pressure, and diastolic blood pressure than both paraplegic patients and non-spinal cord injury patients ( P < 0.001). Baseline vital signs were lower in spinal cord injury patients compared with non-spinal cord injury patients. Lower systolic blood pressure, diastolic blood pressure, and heart rate were associated with higher levels of spinal cord injury. Tetraplegic and paraplegic patients had baseline pyuria above 10 high power field suggesting the criteria for pyuria as a positive indicator of urinary tract infection should be different in patients with spinal cord injury than those without spinal cord injury.