The study aimed to describe and compare hospital admissions due to urinary tract pathology in Australian patients with spinal cord injuries (SCI). Additionally, it sought to identify clinical factors associated with increased hospital admission rates due to urinary tract pathology in these patients.

A retrospective review spanning 13 years (2010-2022) focused on admissions of SCI patients to the two major tertiary spinal centres in New South Wales, Australia. The index admission following the acute spinal cord injury was not included. Univariate and multivariate analyses with negative binomial regression were performed to assess whether there was an association between the level of spinal cord injury characteristics (level and severity) and bladder management with hospital admission rates for urinary tract pathology.

Of the 3750 admissions, 17.3% (n=649) were due to urinary tract pathology. The mean length of hospital stay was 10.3 days (SD 19.3). The primary causes for hospital admission were urinary tract infections (UTIs) requiring intravenous antibiotics (n=413, 63.6%), urolithiasis (n=84, 12.9%) and catheter-related complications (n=65, 10.0%). The most common pathogens identified in patients suffering from UTIs were Escherichia (16.7%), Pseudomonas (15.3%) and Klebsiella (9.5%). Both univariate and multivariate analysis revealed that cervical cord injury level and a suprapubic catheter for bladder management significantly increased the risk of admission.

Genitourinary complications, particularly recurrent UTIs, are a major cause of hospital admissions in patients with spinal cord injuries. Patients with cervical spine injuries and those managing their bladder with suprapubic catheters are at higher risk of hospital admission. These insights can assist clinicians in identifying high-risk SCI patients and implementing preventive strategies to reduce admissions.