How successful is the transition to adult urology care in spina bifida? A single center 7-year experience

Summary Introduction Rates of successful transition from adolescent to adult spina bifida (SB) care are unknown. Objective We aimed to assess rates and predictors of successful transition from a multidisciplinary SB clinic to a transitional urology clinic (TUC), or a pediatric or adult urologist. St...

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Bibliographic Details
Published in:Journal of pediatric urology 2017-02, Vol.13 (1), p.40.e1-40.e6
Main Authors: Szymanski, Konrad M, Cain, Mark P, Hardacker, Thomas, Misseri, Rosalia
Format: Article
Language:English
Subjects:
Adolescent
Ambulatory Care Facilities - standards
Female
Follow-Up Studies
Humans
Male
Pediatrics
Retrospective Studies
Self Care - standards
Spina bifida
Spinal Dysraphism - surgery
Surveys and Questionnaires
Time Factors
Transition to Adult Care - standards
Transitional urology
Urinary tract reconstruction
Urologic Surgical Procedures - methods
Urology
Young Adult
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Summary:Summary Introduction Rates of successful transition from adolescent to adult spina bifida (SB) care are unknown. Objective We aimed to assess rates and predictors of successful transition from a multidisciplinary SB clinic to a transitional urology clinic (TUC), or a pediatric or adult urologist. Study design We retrospectively reviewed patients discharged from a multidisciplinary SB clinic (2006–2012, see Figure ), collecting demographic and clinical data. At transition, all patients/families were given instructions to arrange an appointment within 12 months. Patients who followed-up within 2 years were classified as transitioned. Logistic regression was used for analysis. Results Of 77 patients discharged at a mean age of 19.1 years, 31 (40.3%) successfully transitioned (mean follow-up 4.7 years). Only 20/41 (48.8%) with prior bladder augmentation, urinary channel, and MACE transitioned. There was no significant change in patients transitioning over time or late catch-up presentations ( p ≥0.41). Transitioned and non-transitioned groups were similar in age, gender, home-to-clinic distance, insurance, ambulation, shunt status, prior non-adherence, emergency room visits, neurosurgery appointments, hospitalizations, and surgeries (including genitourinary reconstruction) before discharge ( p ≥0.22). Transitioned patients had more pre-discharge appointments with services outside the SB clinic ( p =0.01) and radiographic studies ( p
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2016.09.020