1. Male gender, ethnicity, and insurance status were associated with adverse functional outcomes of patients with spina bifida.
2. The location of the spina bifida defect was associated with all outcomes (bowel/bladder continence, patient mobility, and the development of pressure sores).
Evidence Rating Level: 2 (Good)
Study Rundown: Significant advances in medical care have improved the quality of life and life expectancy for patients with spina bifida (SB). The effects of SB on each patient vary greatly depending on the type and location of the defect, but other external factors may play a role in the outcomes of this disease. Researchers of the current study sought to determine the impact of sociodemographic and intrinsic lesion characteristics on functional outcomes for SB. Results indicated that older ages were associated with increased continence, more pressure sores, and decreased ambulation. Patients without private insurance and males were more likely to lack bowel/bladder continence and to have limited ambulation. Non-Hispanic blacks were less likely to be continent. Results of this study may be limited by lack of generalizability and selection bias as participating study clinics may not be representative of the entire SB population. However, results were significant and may help clinicians to focus on specific populations and subsequently provide more targeted and appropriate care.
Relevant Reading: Spina bifida outcome: A 25-year prospective
In-Depth [retrospective cohort]: Data from 2054 patients with SB (< 22 years of age) were collected from the National SB Patient Registry (a compilation of patient data from 10 SB clinics) during the years of 2009-2012. The association between outcomes of the disease (pressure sores, mobility, and bowel/urinary continence) and sociodemographic characteristics were studied using multivariate regression analysis while controlling for SB clinic, SB type, and the level of the lesion. Females were more likely to have bowel (aOR 1.34, 95%CI 1.08-1.67) and urinary (aOR 1.29,95% CI 1.03-1.61) continence as well as be community ambulatory (aOR 1.54, 95%CI 1.14-2.08). Patients without private insurance were less likely to have bowel (aOR 0.49, 95%CI 0.39-0.61)/urinary (aOR 0.56, 95%CI 0.45-0.70) continence and less likely to be community ambulatory (aOR 0.68, 95%CI0.49-0.95). Non-Hispanic blacks were less likely to have bowel (aOR 0.37, 95%CI 0.22-0.60) and urinary continence (aOR 0.50, 95%CI 0.31-0.78). Level of the lesion was associated with all outcomes. SB type was associated with all except pressure sores. Age also showed a significant relationship with all outcomes.
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