{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:15:34Z","timestamp":1775063734043,"version":"3.50.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spinal Cord"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Study Design<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To characterize guideline-discordant clean intermittent catheterization (CIC) during hospitalizations of patients with spinal cord injury (SCI), explore predictors of guideline-discordant CIC, and examine its association with urinary tract infection (UTI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>Acute care hospitals within a large academic health system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using electronic health records (9\/1\/2021-9\/30\/2023), we identified adults hospitalized with a discharge diagnosis of SCI and \u22651 documented CIC bladder output. The primary outcome was guideline-discordant CIC (bladder output volume &gt;500\u2009mL and\/or time between CIC\u2009&gt;\u20096\u2009h). Generalized linear model and Chi-square test were used to evaluate patient factors and UTI risk associated with guideline-discordant CIC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study included 413 patients with SCI covering 8,016 CIC measurements during 519 hospitalizations. Their mean (SD) age was 55.2 (20.6) years, with 34.7% female and 46.8% Black. 52.8% were covered by Medicare. 79.4% had a thoracolumbar-level SCI. 50.2% of CICs were guideline-discordant. Males and those with managed care insurance had significantly higher odds of guideline-discordant CIC (OR\u2009=\u20091.34, 95% CI, 1.03 to 1.73 and OR\u2009=\u20092.05, 95% CI, 1.18 to 3.54, respectively). Patients with an indwelling catheter for \u226512 days before initiating CIC had significantly lower odds of guideline-discordant CIC (OR\u2009=\u20090.65, 95% CI, 0.49 to 0.84). The UTI incidence was 12.5% in hospitalizations with guideline-discordant CIC compared to 10.4% with guideline-concordant CIC (<jats:italic>P<\/jats:italic>\u2009=\u20090.49).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Half of CICs did not adhere to guidelines, highlighting the need for quality improvement initiatives. Further research examining the association between UTI and CIC care patterns is warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41393-025-01078-w","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T13:20:15Z","timestamp":1745932815000},"page":"270-276","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Quantifying guideline-discordant intermittent catheterization in adults hospitalized with spinal cord injury: a retrospective cohort study"],"prefix":"10.1038","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2144-5503","authenticated-orcid":false,"given":"Mengdong","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Hon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0482-8609","authenticated-orcid":false,"given":"Stephen","family":"Hampton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8137-2900","authenticated-orcid":false,"given":"Kimberly","family":"Waddell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"1078_CR1","doi-asserted-by":"publisher","first-page":"21S","DOI":"10.1177\/2192568217703088","volume":"7","author":"MG Fehlings","year":"2017","unstructured":"Fehlings MG, Tetreault LA, Riew KD, Middleton JW, Wang JC. 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The contents of this work do not represent the view of the Veterans Health Administration or the United States government.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors certify that this study received approval from the Institutional Review Board at the University of Pennsylvania. All methods were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}