Urological disorders are still the leading cause of inhospital death in patients with spina bifida

Benoit Peyronnet (1, 2, 3) , Fei Gao (4, 5, 6) , Charlène Brochard (1, 2, 3) , Emmanuel Oger (1, 5) , Lucie-Marie Scailteux (1, 5) , Frédéric Balusson (1, 5) , Juliette Hascoet (1, 3, 2) , Quentin Alimi (1) , Zine-Eddine Khene (1) , Sahar Bayat (4) , Magali Jezequel (1) , Camille Olivari (1) , Caroline Voiry (1) , Jacques Kerdraon , Guillaume Bouguen (1, 2, 3) , Xavier Gamé (7) , Laurent Siproudhis (1, 2, 3) , Andrea Manunta (1, 3, 2)

1 CHU Pontchaillou [Rennes]
2 NuMeCan - Nutrition, Métabolismes et Cancer
3 CIC - Centre d'Investigation Clinique [Rennes]
4 EHESP - École des Hautes Études en Santé Publique [EHESP]
5 REPERES - Recherche en Pharmaco-épidémiologie et Recours aux Soins
6 METIS - Département Méthodes quantitatives en santé publique
7 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse

Objective - To assess and analyze the contemporary causes of in-hospital deaths of spina bifida patients. Methods - It was a cross-sectional observational study of the longitudinal national cohort of all patients hospitalized in French public and private hospitals. We analyzed the data from the French hospital discharge database (Programme de Médicalisation des Systemes d'Information, PMSI) from 2009 to 2014. The number of in-hospital deaths was extracted using the combination of the ICD-10 codes "Q05" or "Q760" and a discharge code = 9. Results - There were 138 in-hospital deaths of spina bifida patients over the 6-year study period. The median age at death was 41 years (IQR: 25-52). The median age at death was significantly lower in patients with vs without hydrocephalus (26.6 vs 45.5 years; P <.0001). The leading cause of in-hospital death was urologic disorders (n = 24; 17.3%). Other main causes of death were pulmonary disorders (n = 23; 16.7%), neurologic disorders (n = 19; 13.8%), and bowel disorders (n = 15; 10.9%). Upper urinary tract damage accounted for most of the urologic causes of death: 8 patients died from urinary tract infections (33.3%), 7 patients died from renal failure (29.2%), 4 died from bladder cancer (16.7%), and 5 from other urologic causes. The only variable significantly associated with a death from urologic causes was the absence of hydrocephalus (OR = 0.26; P = .009). Conclusion - Urologic disorders remain the leading cause of in-hospital death in spina bifida patients in France. The present study highlights that efforts to improve the urologic management of the spina bifida population are still greatly needed.

Keywords: Epidemiology; Death; Urinary; Spina bifida; Bladder; Urological disorder

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology; Urology and Nephrology

Benoit Peyronnet, Fei Gao, Charlène Brochard, Emmanuel Oger, Lucie-Marie Scailteux, et al.. Urological disorders are still the leading cause of inhospital death in patients with spina bifida. Urology, 2020, 137, pp.200-204. ⟨10.1016/j.urology.2019.11.006⟩. ⟨hal-02394268⟩