# Quantifying the Cardiovascular and Immunologic Changes after Spinal Cord Injury to Aid Diagnosis of Clinically Meaningful Infections

> **NIH NIH R03** · BAYLOR COLLEGE OF MEDICINE · 2022 · $160,000

## Abstract

7. Project Summary/Abstract
Urinary tract infection (UTI, including catheter-associated UTI), is consistently amongst the top three reasons
for health care use for persons with spinal cord injury (SCI), with a yearly cost of over $2 billion, not to mention
the significant impact of the condition on quality of life. While the importance of recognizing and treating true
UTI is evident, distinguishing this condition from asymptomatic bacteriuria (ASB, a positive urine culture
without clinical signs or symptoms of infection) is particularly challenging after SCI due to the impaired ability to
sense the most common signs and symptoms used in UTI diagnosis. This often leads to subjective
interpretations of UTI signs and symptoms by patients and SCI providers alike. Bladder instrumentation with
either indwelling or intermittent catheterization is often necessary after SCI to safely eliminate urine and
maintain continence, however leads to high rates of ASB that do not need to be treated. Inappropriate
treatment of ASB with antibiotics leads to the development of multi-drug resistant organisms, which are higher
in persons with SCI than their age and co-morbidity-matched cohorts, conveying high morbidity and mortality.
A possible solution to this conundrum is a diagnostic support tool for UTI after SCI; previously successful tools
measure the degree of abnormality of multiple physiologic variables to measure the severity of acute disease.
To calculate the degree of abnormality, however, we must have a better sense of the normal values for vital
sign measurements and common laboratory studies for the SCI patient population. Therefore, the aims of this
study are to 1) Establish the association between chronic SCI and baseline vital sign and lab measurements
through a case-control study utilizing national Veterans Health Administration (VHA) data sources; and 2)
Determine the positive predictive value of a constellation of physiologic variables defined as a screening tool
for severe UTI after SCI through a retrospective cohort study. The data obtained from this study will support a
NIH R01 proposal aimed to externally validate and assess the performance of the severe UTI screening tool
prospectively. The assembled study team and environment are uniquely suited to completing this work, and
have the support of clinical, research, administrative and patient advocacy leadership locally and nationally.
This project supports the NICHD/NCMRR priority of identifying and treating secondary conditions associated
with disability.

## Key facts

- **NIH application ID:** 10380502
- **Project number:** 1R03HD107667-01
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Felicia Skelton
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $160,000
- **Award type:** 1
- **Project period:** 2022-03-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10380502

## Citation

> US National Institutes of Health, RePORTER application 10380502, Quantifying the Cardiovascular and Immunologic Changes after Spinal Cord Injury to Aid Diagnosis of Clinically Meaningful Infections (1R03HD107667-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10380502. Licensed CC0.

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