Below the Belt: Risk Factors for Urologic Adverse Events After Central Cord Syndrome.

Abstract

Retrospective observational study. This study aimed to identify predictors of AEs in central cord syndrome (CCS) patients and specifically characterize predictors of urologic/incontinence adverse events (AEs). CCS is an incomplete spinal cord injury characterized by predominant upper extremity sensory and motor dysfunction. Few studies have explored urodynamic function in CCS patients, and none have comprehensively analyzed urologic AEs and their predictors. Data from 41 CCS patients (12F) admitted over a 3-year period were retrospectively reviewed. Variables collected included ASIA score, comorbidities, medications, admission blood glucose, mean arterial pressure, vasopressor use, and AEs. CCS diagnosis was confirmed by magnetic resonance imaging, as well as the presence of CCS as defined by ASIA standards. Binary logistic regression identified predictors of any complication, followed by a subset analysis for urologic and incontinence AEs. Severe injury (ASIAC) was a strong and significant predictor of overall AEs (χ²=8.47, OR=9.38, P=0.004). Urologic/incontinence AEs, observed in 18/23 patients with any AEs, included urinary tract infection (UTI), neurogenic bladder/bowel, and urinary retention. Predictors of urogenital AEs were not taking statins (χ²=4.50, OR=0.024, P=0.034) and high admission blood glucose, though glucose was not significantly different between groups (χ²=3.30, OR=1.03, P=0.070). Severe CCS increases the likelihood of AEs, particularly urologic/incontinence issues. Elevated blood glucose may heighten infection and neuropathy risks, leading to lower urinary tract symptoms. Statins may mitigate this risk through anti-inflammatory and endothelial-protective effects, improving urinary tract blood flow.