title: Risk factors to develop autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury.
abstract: The risk factors for developing autonomic dysreflexia (AD) during urodynamic (UD) examination in patients with spinal cord injury (SCI) above Th6 still remain unclear. The main goal of our study is to investigate the risk factors that could be associated with AD in these particular patients.
  
  
  
  Cross sectional survey.
  
  
  
  The study was carried out in 83 patients with SCI above Th6 who were submitted to our center for a UD examination. AD was defined as a rise in systolic blood pressure above 15 mm Hg with a pulse rate below 60 beats per minute.
  
  
  
  The prevalence rate of AD among our patients was 54%. Univariate analysis of our study showed the following risk factors: patient's age, SCI completeness, traumatic etiology, indwelling catheter, presence of chills or sweating, anticholinergic treatment, maximum detrusor voiding pressure, detrusor pressure at maximum flow rate, detrusor external sphincter dyssynergia, and bladder outlet obstruction. Using multivariate logistic regression, we found that there are only two independent risk factors: patient's age equal to or above 45 years of age (OR = 10.995) and maximum detrusor voiding pressure equal to or above 31 cm H2O (OR = 3.879).
  
  
  
  According to our results, the patient's age and maximum detrusor voiding pressure should be considered at the time of performing a UD examination in order to prevent the sudden onset of AD in patients with SCI above Th6. Neurourol. Urodynam. 36:171-175, 2017. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, Paraplegics National Hospital, Toledo, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Vírseda-Chamorro
authors.affiliation: Department of Urology, Hospital Clínico de San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Salinas-Casado
authors.affiliation: Department of Urology, Hospital Virgen del Prado, Talavera, Toledo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Gutiérrez-Martín
authors.affiliation: Department of Urology, Paraplegics National Hospital, Toledo, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: de la Marta-García
authors.affiliation: Department of Urology, Paraplegics National Hospital, Toledo, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: López-García-Moreno
authors.affiliation: Department of Urology, Paraplegics National Hospital, Toledo, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Esteban Fuertes
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D020211:Autonomic Dysreflexia / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000503:physiopathology; D014563:Urodynamics
keywords: autonomic dysreflexia; risk factors; spinal cord injuries; urodynamics