Physiologic Differences in Vital Signs and Urine Tests in Spinal Cord Injury and the Effects on Urinary Tract Infection Diagnosis

To establish the physiologic baseline (person's physiologic state when their health is stable) for vital signs and urine lab measurements after spinal cord injury (SCI). This case-control study using outpatient data from the national Veteran's Health Administration Corporate Data Warehouse included 2,000 Veterans with SCI (cases) and 2,000 Veterans without SCI (controls) between 2018-2019. Cases and controls were randomly selected, and frequency matched for age, sex, race, ethnicity, and Deyo comorbidity index. SCI patients had lower temperature, heart rate, respiratory rate, and systolic and diastolic blood pressures than non-SCI (p < 0.05). Pyuria and hematuria were higher in SCI patients, with approximately 73% of tetraplegic and paraplegic patients having urine white blood cells above 10 HPF. Tetraplegic patients had lower heart rate, systolic and diastolic blood pressure than both paraplegic patients and non-SCI patients (p < 0.001). Baseline vital signs were lower in SCI patients compared to non-SCI patients. Lower systolic blood pressure, diastolic blood pressure, and heart rate were associated with higher levels of SCI. Tetraplegic and paraplegic patients had baseline pyuria above 10 HPF suggesting the criteria for pyuria as a positive indicator of UTI should be different in patients with SCI than those without SCI.