Bladder Reconstruction Rates Differ Among Centers Participating in National Spina Bifida Patient Registry

Details

• Alternative Title:
  J Urol
• Personal Author:
  Routh, Jonathan C. ; Joseph, David B. ; Liu, Tiebin ; Schechter, Michael S. ; Thibadeau, Judy K. ; Wallis, M. Chad ; Ward, Elisabeth A. ; Wiener, John S.
• Description:
  Purpose ; We performed an exploratory analysis of data from the National Spina Bifida Patient Registry (NSBPR) to assess variation in the frequency of bladder reconstruction surgeries among NSBPR centers. ; Methods ; We queried the 2009–2014 NSBPR to identify patients who had ever undergone bladder reconstruction surgeries. We evaluated demographic characteristics, SB type, functional level, mobility, and NSBPR center to determine whether any of these factors were associated with reconstructive surgery rates. Multivariable logistic regression was used to simultaneously adjust for the impact of these factors. ; Results ; We identified 5,528 patients with SB enrolled in the NSBPR. Of these, 1,129 (20.4%) underwent bladder reconstruction (703 augmentation, 382 continent catheterizable channel, 189 bladder outlet procedure). Surgery patients were more likely to be older, female, non-Hispanic white, higher lesion level, myelomeningocele diagnosis, non-ambulators (all p<0.001) and non-privately insured (p=0.018). Bladder reconstruction surgery rates varied among NSBPR centers (range 12.1–37.9%, p<0.001). After correcting for known confounders, NSBPR center, SB type, mobility, gender and age (all p<0.001) were significant predictors of surgical intervention. Race (p=0.19) and insurance status (p=0.11) were not associated with surgical intervention. ; Conclusions ; There is significant variation in rates of bladder reconstruction surgery among NSBPR centers. In addition to clinical factors such as mobility status, lesion type, and lesion level, non-clinical factors such as patient age, gender and treating center are also associated with the likelihood of an individual undergoing bladder reconstruction.
• Keywords:
  • Pediatrics
  • Urology
  • Spina Bifida
  • Clinical Care Variation
  • Neurogenic Bladder
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  More +
• Source:
  J Urol. 199(1):268-273
• Pubmed ID:
  28830753
• Pubmed Central ID:
  PMC5760329
• Document Type:
  Journal Article
• Funding:
  U01 DD000742/DD/NCBDD CDC HHSUnited States/ ; U01 DD001082/DD/NCBDD CDC HHSUnited States/ ; U01 DD001278/DD/NCBDD CDC HHSUnited States/ ; U01 DD001060/DD/NCBDD CDC HHSUnited States/ ; K08 DK100534/DK/NIDDK NIH HHSUnited States/ ; U01 DD001087/DD/NCBDD CDC HHSUnited States/ ; U01DD001087/ACL/ACL HHSUnited States/ ; U01 DD001062/DD/NCBDD CDC HHSUnited States/
• Volume:
  199
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/50785/cdc_50785_DS1.pdf
• File Type:
  [PDF - 92.79 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:29c3c5a015b08e7753ed2106e889c1f9d411e81beffb2d55f7eca44b0e579150