{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:48:53Z","timestamp":1792612133280,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90RTHF0003\u201001\u201000"],"award-info":[{"award-number":["90RTHF0003\u201001\u201000"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005191","name":"Craig H. Neilsen Foundation","doi-asserted-by":"publisher","award":["642820"],"award-info":[{"award-number":["642820"]}],"id":[{"id":"10.13039\/100005191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neurogenic bladder (NB) following spinal cord injury (SCI) is associated with significant morbidity, yet early characterization remains limited. Urodynamic studies (UDS), the gold standard for evaluation, are not routinely performed early after SCI due to unclear guidelines and limited access. We evaluated whether urinary biomarkers could identify high\u2010risk bladder phenotypes early after SCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a prospective cohort study of 45 individuals with acute SCI (\u2264\u20096 weeks post\u2010injury), including 35 catheter\u2010dependent participants who underwent UDS and 10 spontaneously voiding controls without UDS. Urine samples were analyzed by nine biomarkers using ELISA. High\u2010risk bladder was defined as detrusor overactivity (DO), detrusor sphincter dyssynergia (DSD), elevated detrusor pressure (\u2265\u200940\u2009cm H\n                      <jats:sub>2<\/jats:sub>\n                      O), or low compliance (&lt;\u200915\u2009mL\/cm H\n                      <jats:sub>2<\/jats:sub>\n                      O). Biomarker performance was assessed using penalized regression with bootstrap\u2010corrected metrics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individual biomarkers demonstrated moderate discrimination, including NGAL for DO (AUC 0.75), NGAL for DSD (AUC 0.84), and RANTES\/CCL5 for elevated detrusor pressure (AUC 0.73). A multivariable panel improved detection of high\u2010risk bladder (AUC 0.73, 95% CI 0.59\u20130.89). At a sensitivity\u2010optimized threshold, the model achieved sensitivity 0.94, negative predictive value 0.92, and negative likelihood ratio 0.16. Model discrimination was preserved after accounting for urinary inflammation, although individual biomarkers showed differential sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urinary biomarkers show promise as a noninvasive approach to identify individuals with early SCI at risk for adverse urodynamic findings. This approach may support earlier risk stratification and targeted use of UDS during inpatient rehabilitation. Larger studies are needed to validate these findings and define their clinical role.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      This study was conducted as part of a registered clinical trial (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      Identifier: NCT04350359).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70378","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:11:20Z","timestamp":1784034680000},"page":"1536-1544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary Biomarkers for Screening High\u2010Risk Urodynamic Phenotypes in Early Spinal Cord Injury: A Pilot Study"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-1070","authenticated-orcid":false,"given":"Catherine","family":"Forster","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danira Garcia","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"UTHealth Houston McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6713-1679","authenticated-orcid":false,"given":"Rose","family":"Khavari","sequence":"additional","affiliation":[{"name":"Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6039-2070","authenticated-orcid":false,"given":"Bich Na","family":"Choi","sequence":"additional","affiliation":[{"name":"UTHealth Houston McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-1959","authenticated-orcid":false,"given":"Suzanne","family":"Groah","sequence":"additional","affiliation":[{"name":"MedStar National Rehabilitation Hospital and MedStar Georgetown University Hospital Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4600-6208","authenticated-orcid":false,"given":"Argy","family":"Stampas","sequence":"additional","affiliation":[{"name":"UTHealth Houston McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"\u201cFacts and Figures at a Glance \u201d National Spinal Cord Injury Statistical Center 2023 https:\/\/www.nscisc.uab.edu\/Public\/Facts%20and%20Figures%20-%202023.pdf."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7174"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)61055-3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11042.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63786-8"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.01.046"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(07)61602-x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23369"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1179\/1079026812z.00000000053"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0895-4356(01)00341-9"},{"key":"e_1_2_11_12_1","unstructured":"\u201cTraumatic Spinal Cord Injury Demographics at a Glance 2026 \u201d National Spinal Cord Injury Statistical Center 2026."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23539"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20519"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.12.008"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000090192.36436.d5"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.7150\/thno.112163"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/mi.2012.109"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)32685-x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14186"},{"issue":"5","key":"e_1_2_11_21_1","first-page":"527","article-title":"Bladder Management for Adults With Spinal Cord Injury: A Clinical Practice Guideline for Health\u2010Care Providers","volume":"29","author":"Consortium for Spinal Cord Medicine","year":"2006","journal-title":"Journal of Spinal Cord Medicine"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000002235"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.026"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70378","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:34:26Z","timestamp":1792611266000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/nau.70378"],"URL":"https:\/\/doi.org\/10.1002\/nau.70378","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"2026-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}